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Multiple strokes due to pulmonary arteriovenous malformation.
Arsalan Talib Hashmi1, Asiya Batool2, Mazin O Khalid1
1Department of Cardiology, Maimonides Medical Center, 4802 10th Ave, Brooklyn, NY, USA.
Radiology Case Reports
|July 26, 2021
Summary
Recurrent strokes can occur with absent left internal carotid artery and pulmonary arteriovenous malformations (PAVMs). Embolotherapy effectively treats PAVMs, significantly reducing stroke risk.
Area of Science:
- Cardiology
- Neurology
- Radiology
Background:
- Pulmonary arteriovenous malformations (PAVMs) create abnormal connections between pulmonary arteries and veins.
- These shunts cause extracardiac right-to-left blood flow, increasing stroke risk via paradoxical embolization.
- PAVMs are frequently hereditary and associated with hereditary hemorrhagic telangiectasias (HHT).
Observation:
- A patient presented with recurrent strokes.
- The patient had an absent left internal carotid artery (ICA).
- Transthoracic echocardiogram with bubble study revealed delayed bubbles in the left ventricle, suggesting PAVMs.
Findings:
- Computed tomography (CT) scan of the chest confirmed the diagnosis of PAVMs.
- The patient's condition involved both an absent left ICA and PAVMs.
- Percutaneous embolotherapy was identified as the primary treatment.
Implications:
- Early detection of PAVMs is crucial for stroke prevention.
- Echocardiogram with bubble study can be an initial diagnostic clue for PAVMs.
- Percutaneous embolotherapy offers a successful treatment option, reducing stroke risk in patients with PAVMs.
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