Pulmonary Arteriovenous Malformations

摘要

P rogressive dyspnea prompted a 24-year-old woman to seek medical attention. Initially, her symptoms occurred only with exertion, but they later occurred at rest as well. She had no fever, chills, hemoptysis, or chest pain. Physical examination findings were unremarkable with no expiratory wheezing, symmetric chest wall excursion, and good air movement in both lung fields.Her arterial blood gas values on 60% oxygen delivered by face mask were consistent with hypoxemic respiratory failure: pH was 7.4; PCO_2, 34.3 mm Hg; and PO_2, 61 mm Hg. The only significant laboratory finding was polycythemia with a hemoglobin level of 16.7 g/dL and a he-matocrit of 49.4%, which suggested chronic hypoxia.