DOI: 10.12890/2024_005027

Pulmonary arteriovenous malformation: not all hypoxemia during COVID-19 is the same

Authors

  • Ramitha Ramachandran Department of Critical Care Medicine, Aster Medcity, Kochi, India
  • Anuroop Balagopal Department of Critical Care Medicine, Aster Medcity, Kochi, India
  • Nilanjan Umesh Department of Critical Care Medicine, Aster Medcity, Kochi, India
  • Manjush Karthika Faculty of Medical and Health Sciences, Liwa College, Abu Dhabi, United Arab Emirates

manjushnair@hotmail.com

Keywords

Pulmonary arteriovenous malformation, hypoxemia, COVID-19

Abstract

Hypoxemia in coronavirus disease 2019 (COVID-19) patients is not solely due to alveolar damage but can also involve factors like vascular shunts, such as pulmonary arteriovenous malformation, contributing to persistent hypoxemia. We report a case of a 59-year-old male, with COVID-19 pneumonia, requiring high-flow respiratory support, who later was also diagnosed with a large pulmonary arteriovenous fistula, which probably worsened because of COVID-19 infection.

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References

  1. Qanadli SD, Beigelman-Aubry C, Rotzinger DC. Vascular Changes Detected With Thoracic CT in Coronavirus Disease (COVID-19) Might Be Significant Determinants for Accurate Diagnosis and Optimal Patient Management. AJR Am J Roentgenol 2020;215: W15.
  2. Qanadli SD, Rocha AC, Rotzinger DC. Case Report: Intrapulmonary Arteriovenous Anastomoses in COVID-19-Related Pulmonary Vascular Changes: A New Player in the Arena? Front Med (Lausanne) 2021;8:639152.
  3. Gattinoni L, Coppola S, Cressoni M, Busana M, Rossi S, Chiumello D. COVID-19 Does Not Lead to a “Typical” Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med 2020;201:1299-1300.
  4. Shovlin CL. Pulmonary arteriovenous malformations. Am J Respir Crit Care Med 2014;190:1217-1228.
  5. Allen SW, Whitfield JM, Clarke DR, Sujansky E, Wiggins JW. Pulmonary arteriovenous malformation in the newborn: a familial case. Pediatr Cardiol 1993;14:58-61.
  6. Moussouttas M, Fayad P, Rosenblatt M, Hashimoto M, Pollak J, Henderson K, et al. Pulmonary arteriovenous malformations: cerebral ischemia and neurologic manifestations. Neurology 2000;55:959-964.
  7. Cottin V, Chinet T, Lavolé A, Corre R, Marchand E, Reynaud-Gaubert M, et al. Pulmonary arteriovenous malformations in hereditary hemorrhagic telangiectasia: a series of 126 patients. Medicine (Baltimore) 2007;86:1-17.
  8. Mangla A, Nevares A, Yamani N, Ansari N. Pulmonary arteriovenous malformation: a rare cause of dyspnoea on exertion. BMJ Case Rep 2014;2014:bcr2014204087.
  9. Tobin CE. Arteriovenous shunts in the peripheral pulmonary circulation in the human lung. Thorax 1966;21:197-204.
  10. Tobin CE, Zariquiey MO. Arteriovenous shunts in the human lung. Proc Soc Exp Biol Med 1950;75:827-829.
  11. Lovering AT, Duke JW, Elliott JE. Intrapulmonary arteriovenous anastomoses in humans--response to exercise and the environment. J Physiol 2015;593:507-520.
  12. Mohamed I, de Broucker V, Duhamel A, Giordano J, Ego A, Fonne N, et al. Pulmonary circulation abnormalities in post-acute COVID-19 syndrome: dual-energy CT angiographic findings in 79 patients. Eur Radiol 2023;33:4700-4712.
  13. Gossage JR, Kanj G. Pulmonary arteriovenous malformations. A state of the art review. Am J Respir Crit Care Med 1998;158:643-661.
  14. Mottaghi H, Kahrom M, Nezafati MH, Kahrom H. Congenital pulmonary arteriovenous malformation: a rare cause of cyanosis in childhood. Pan Afr Med J 2009:8;3-12.
  15. Faughnan ME, Palda VA, Garcia-Tsao G, Geisthoff UW, McDonald J, Proctor DD et al. HHT Foundation International - Guidelines Working Group. International guidelines for the diagnosis and management of hereditary haemorrhagic telangiectasia. J Med Genet 2011;48:73-87.

Published

2024-11-25

How to Cite

1.
Ramachandran R, Balagopal A, Umesh N, Karthika M. Pulmonary arteriovenous malformation: not all hypoxemia during COVID-19 is the same. EJCRIM [Internet]. 2024 Nov. 25 [cited 2026 Nov. 3];11(12). Available from: https://ejcrim.com/index.php/ejcrim/article/view/5027