Different strokes for different folks

A 42-year-old woman, presented to our emergency room with chief complaints of acute onset of dyspnea, left-sided chest pain, and respiratory distress. On arrival, she had blood pressure of 90/50 mm Hg, respiratory rate of 40/min, and oxygen saturation of 95% breathing on 10 L oxygen. She was in significant respiratory distress. On examination, she was found to have diminished breath sounds on the left side of chest. Her chest radiograph showed left massive pleural effusion causing contralateral shift of mediastinum. Diagnostic pleural aspiration was done; results were consistent with hemothorax. Her multidetector computed tomography chest showed features of left-sided hemothorax (high attenuation) along with a 2 cm-enhancing lobulated opacity in the left lingular lobe, suggestive of pulmonary arteriovenous malformation (PAVM). She was successfully treated with surgical resection of PAVM.