Related Experiment Video
Updated: Jul 23, 2025
07:41
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
3.7K
Positive Bubble Study But No Evidence of Interatrial Defect in a Patient with Recurrent Cryptogenic Stroke
Nika Samadzadeh Tabrizi1, Perry A Stout1, Joseph Cahill2
1Albany Medical College, New York, United States.
Turkish Journal of Anaesthesiology and Reanimation
|July 17, 2023
Summary
Pulmonary arteriovenous malformations (PAVMs) can cause serious complications and are often misdiagnosed as intracardiac shunts. Echocardiography can differentiate PAVMs from patent foramen ovale (PFO) or atrial septal defects (ASD).
Area of Science:
- Cardiology
- Radiology
- Pulmonology
Background:
- Pulmonary arteriovenous malformations (PAVMs) are often underdiagnosed due to rarity misconceptions.
- PAVMs can lead to severe complications like brain abscesses and cryptogenic emboli.
- Echocardiography findings of PAVMs can mimic intracardiac shunts (PFO/ASD), leading to misdiagnosis.
Purpose of the Study:
- To highlight the diagnostic challenges in PAVM identification.
- To emphasize the importance of recognizing unique echocardiographic features differentiating PAVMs from intracardiac shunts.
- To present a case of recurrent cryptogenic strokes misattributed to PFO, with PAVM diagnosed late.
Main Methods:
- Case report detailing a patient's diagnostic journey.
- Review of echocardiographic findings in PAVM versus intracardiac shunts.
- Analysis of diagnostic errors and delayed treatment.
Main Results:
- The patient experienced recurrent cryptogenic strokes.
- Initial diagnosis misattributed symptoms to a patent foramen ovale (PFO).
- Multiple PAVMs were correctly diagnosed only after two failed PFO closure attempts.
Conclusions:
- PAVMs represent an important alternative etiology for right-to-left shunting.
- Echocardiographers must be aware of specific imaging features to distinguish PAVMs from intracardiac defects.
- Timely and accurate diagnosis of PAVMs is crucial to prevent severe morbidity and mortality.
Keywords:
Arteriovenous malformationechocardiographyischemic strokepatent foramen ovalesaline contrast studyMore Related Videos
Related Concept Videos
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
305
Echocardiography plays a role in assessing cardiac health and detecting heart conditions, with various types providing critical insights for diagnosis and treatment.
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
305
01:30Acute Coronary Syndrome III: Diagnostic Studies
10
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
10
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
10
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
10
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
32
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
32
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
23
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
23
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
12
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
12