Subject(s)
Glomerulonephritis/complications , Hemoptysis/complications , Adolescent , Adult , Anemia, Hypochromic/complications , Anti-Glomerular Basement Membrane Disease/diagnosis , Diagnosis, Differential , Glomerulonephritis/diagnosis , Hemoptysis/diagnosis , Humans , Immune Complex Diseases/complications , MaleABSTRACT
A case of pulmonary arterio-venous microfistula in a fifteen year old male is reported. He referred dyspnea and cyanosis for 3 and 2 years respectively. Physical examination was normal except for finger clubbing. Chest radiograph and EKG were also normal. Lung function tests showed hypoxemia due to an increase in veno-arterial shunt (Qs/Qt). Its localization was not apparent by routine studies such as phonocardiogram, echocardiogram, right heart catheterization and pulmonary angiogram. However, a contrast echocardiogram and selective occlusion of the right and left pulmonary arteries performed with a Dotter-Lucas catheter were suggestive of an intrapulmonary localization of the shunt. A lung biopsy confirmed the diagnosis.
Subject(s)
Arteriovenous Fistula/diagnosis , Pulmonary Artery , Pulmonary Veins , Adolescent , Arteriovenous Fistula/pathology , Biopsy , Echocardiography , Electrocardiography , Humans , Lung/diagnostic imaging , Lung/pathology , Lung Volume Measurements , Male , RadiographyABSTRACT
A case of pulmonary arteriovenous fistula associated with rheumatic mitral heart disease is presented. We have reviewed the literature and no published case with such association has been described. The loud mitral insufficiency murmur hide the continuous murmur of the fistula. The angiographic study demonstrated the A-V fistula. Retrospectively the diagnosis should have been suspected due to cyanosis, slight clubbing, the radiologic findings and the important Qs/Qt shunt. The associated pulmonary embolic phenomena made more difficult the diagnosis.
