[Congenital pulmonary arterio-venous fistula coexisting with atrial septal defect. A case report]

A case of a 26-year-old patient with a long-lasting history of reduced physical capacity and cyanosis of the distal parts of the limbs is presented. An atrial septal defect of ostium secundum type was detected by echocardiography. However, because the defect was small and the blood shunt was not significant, other causes which might explain clinical symptoms, polyglobulia and hypoxaemia were investigated. Chest X-ray and computerised tomography revealed the presence of pulmonary arterio-venous fistula. The patient underwent surgery which relieved symptoms. Diagnostic difficulties in patients with this condition are discussed.