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A-21-year old woman presented with exertional breathlessness, fatigue and episodic mild haemoptysis for the past 7 months. Peripheral arterial oxygen saturation (SpO2) was 87% on room air. Clubbing and central cyanosis were present. There was no improvement in SpO2 and cyanosis with supplemental oxygen therapy. Chest radiograph revealed a heterogeneous opacity in right upper zone (figure 1A). CT pulmonary angiogram revealed diffuse pulmonary A-V malformation (PAVM) involving apical and anterior segments of right upper lobe with multiple pulmonary arterial branches directly communicating with the pulmonary veins (figure 1B). A subcentrimetric area of diffusely enhancing soft tissue attenuation was seen alongside right lower end of trachea adjacent to PAVM, for …
Footnotes
Contributors NKC was involved in concept/design of study, acquisition and interpretation of data, manuscript preparation and final approval, integrity of work. RR was involved in acquisition and interpretation of data, manuscript preparation and final approval,Integrity of work. BJS was involved in acquisition and interpretation of data, manuscript preparation and final approval. ND was involved in manuscript preparation and final approval.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.