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Isolated Pulmonary Arteriovenous Fistula in a Patient with Recurrent Stroke
Chia-Ching Wang1, Jou-Kou Wang1, Jui-Yu Hsu2
1Department of Pediatrics, National Taiwan University Hospital;
Unlabelled:
Paradoxical embolism is a risk factor for cryptogenic stroke in young adults, and can be primarily attributed to the presence of patent foramen ovale (PFO). Although contrast echocardiography may facilitate diagnosis, it would be difficult to distinguish a PFO from a pulmonary arteriovenous fistula (PAVF), which could also result in paradoxical embolism. We report a 46-year-old woman with recurrent ischemic stroke, who was scheduled for PFO closure because of a right-to-left shunt detected by contrast echocardiography. The diagnosis turned out to be a PAVF confirmed by angiography. Thereafter, coil embolization of this PAVF was performed successfully.
Key Words:
Embolic stroke; Patent foramen ovale; Pulmonary arteriovenous fistula; Right-to-left shunt.
Insights
A patent foramen ovale (PFO) can cause stroke, but a pulmonary arteriovenous fistula (PAVF) may mimic it. This case highlights PAVF misdiagnosis and successful coil embolization treatment for recurrent embolic stroke.
Area of Science:
- Cardiology and Neurology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Paradoxical embolism is a significant risk factor for cryptogenic stroke, particularly in younger adults.
- Patent foramen ovale (PFO) is a common cause of paradoxical embolism.
- Pulmonary arteriovenous fistulas (PAVF) can also lead to paradoxical embolism, posing a diagnostic challenge.
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