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Case report
Exertional hypoxia in a healthy adult: a pulmonary arteriovenous malformation
  1. Kyle Keinath1,
  2. Megan Vaughn2,
  3. Nathan Cole2 and
  4. Shari Gentry2
  1. 1 Diagnostic Radiology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
  2. 2 Department of Medicine, BUMED, Falls Church, Virginia, USA
  1. Correspondence to Dr Kyle Keinath; kyleke{at}


Pulmonary arteriovenous malformations (PAVMs) are a rare cause of pulmonary symptoms, including dyspnoea on exertion, hypoxemia and haemoptysis. PAVMs are an aetiology that is often overlooked by physicians when developing a differential diagnosis for pulmonary symptoms and unidentified lung masses. However, it is an important differential diagnosis to have as PAVMs can have serious sequelae including strokes, brain abscess and life-threatening bleeding. We present a case of an impressive PAVM presenting with chest pain, chronic cough, feelings of anxiety, mild resting hypoxemia and exertional hypoxemia. Of note, on previous chest X-ray, 8 years prior to presentation, an incidental mass was found during a shoulder repair presurgical workup but not further evaluated.

  • radiology
  • respiratory medicine
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  • Contributors The authors contributed in the following ways. KK and NC provided direct patient care. KK, NC and MV researched, wrote and edited the manuscript. SG was the manuscript mentor and edited the manuscript in addition to ensuring the standard of care was met.

  • 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 for publication Obtained.

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

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