BMJ Case Reports 2018; doi:10.1136/bcr-2018-224862
  • Unusual association of diseases/symptoms

Recurrent minor strokes/TIA with a right to left shunt

  1. Ming W Liu3
  1. 1Department of Cardiology, University of New Mexico, Albuquerque, New Mexico, USA
  2. 2Department of Cardiology, Harbor-UCLA/Good Samaritan Hospital, Los Angeles, California, USA
  3. 3Cardiology, White Memorial Medical Center, Los Angeles, California, USA
  1. Correspondence to Dr Manuel Cortes, manuelc1281{at}
  • Accepted 26 June 2018
  • Published 10 July 2018


A patient came to our institution for evaluation and closure of suspected patent foramen ovale actively manifesting as cerebrovascular accident. Through further studies, we found the presence of a pulmonary arteriovenous fistula, which was subsequently and successfully closed through non-invasive percutaneous selective segmental pulmonary artery embolisation.


  • Contributors MC contributed with data collection gathering, designing the case report, data analysis and interpretation. Also contributed by writing the initial and the subsequent drafts after being revised by all the authors involved, as well as submitting the final case report. MWL (deceased) contributed with data analysis and interpretation as well as drafting and critically revising the article. As primary attending, he evaluated patient, made the diagnosis of pulmonary arteriovenous fistula (PAVF) and was the primary operator during the pulmonary angiography as well as the main operator for the closure of the PAVF as described in the manuscript. GSM contributed with data analysis and interpretation as well as drafting and critically revising the article. He approved the final and submitted version of the case report. All authors critically reviewed, edited and approved the manuscript.

  • 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.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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