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Pulmonary arteriovenous malformation — SCE Respiratory MCQ

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HardOtherPulmonary arteriovenous malformationSCE Respiratory

A 46-year-old woman has recurrent epistaxis, mucocutaneous telangiectasia and exertional desaturation. CT pulmonary angiography shows a 4 mm feeding artery to a right lower lobe pulmonary arteriovenous malformation. What is the most appropriate management?

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Correct answer: D — Refer for embolisation assessment and screen for hereditary haemorrhagic telangiectasia

A pulmonary AVM with a feeding artery of this size should be referred for embolisation assessment, and the clinical features suggest hereditary haemorrhagic telangiectasia. Observation alone leaves risk of paradoxical embolic events and brain abscess. Anticoagulation and inhaled therapy do not correct the right-to-left shunt.

Reference: BTS Clinical Statement on Pulmonary Arteriovenous Malformations