Pulmonary Arteriovenous Malformation can be Associated with Embolic Stroke of Undetermined Source (ESUS)

Authors

• Mariana Barros Cruz Internal Medicine Service, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
• Nuno Palma Internal Medicine Service, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
• Joao Rocha Neurology Service, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
• Ricardo Meireles Internal Medicine Service, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal

maryanacbc@gmail.com

Keywords

Abstract

Pulmonary arteriovenous malformations (PAVMs) are rare vascular anomalies. Alternative designations are pulmonary arteriovenous fistulae or aneurysms. Although mostly asymptomatic, PAVMs can cause respiratory symptoms due to right-to-left shunt. The central nervous system is a potential target for complications, including stroke, as a result of paradoxical embolism. In this report, the authors describe an unusual case of cerebral emboli caused by paradoxical embolism through a PAVM, presenting with a broad pathology including orthodeoxia, central cyanosis and digital clubbing, which should be kept in mind since misdiagnosis may cause severe morbidity in young adults.