Article Text
PDF
Abstract
Pulmonary arteriovenous malformation (PAVM) is a rare cause of embolic stroke of undetermined source (ESUS) and can be challenging to diagnose promptly. In this case, a woman in her 40s with ESUS was diagnosed with PAVM after a transoesophageal echocardiography (TOE) microbubble test revealed bubbles flowing from the right superior pulmonary vein. Endovascular treatment was performed, and follow-up transthoracic echocardiography showed no right-to-left shunt, confirming successful shunt closure. This case is significant as it is the first reported instance where both treatment and postoperative evaluation of PAVM were conducted using echocardiography. The early detection of the shunt through the microbubble test, within three cardiac cycles, was crucial and differs from typical delayed shunt detection. This suggests that focused imaging during TOE can enhance diagnostic accuracy for PAVM.
- Venous thromboembolism
- Neurology (drugs and medicines)
- Stroke
Statistics from Altmetric.com
Footnotes
Contributors TS was responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content. MI, YT and YJA gave the final approval of the manuscript. MI acted as a guarantor.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.