Article Text

Download PDFPDF
Systemic arteriopulmonary venous fistula (APVF): case presentation of an asymptomatic individual and a review of the literature
  1. Paul Jenkins1,
  2. Prageeth Dissanayake2 and
  3. Richard Riordan2
  1. 1Radiology, Peninsula Radiology Academy, Plymouth, UK
  2. 2Radiology, University Hospitals Plymouth NHS Trust, Plymouth, Plymouth, UK
  1. Correspondence to Dr Paul Jenkins; pjenkins1{at}nhs.net

Abstract

Abnormal communications between the systemic and pulmonary venous systems are rare but can present as a opacity on chest radiograph. A solitary vessel communicating as a fistula directly between the systemic arterial circulation and the pulmonary venous system is not widely described. These may have significant implications in the long-term cardiovascular health of an individual acting as a left to right shunt. There is no clear consensus as to the management, but surgical management and endovascular embolisation have been successfully used. We present a case where a systemic arteriaopulmonary fistula originating from the abdominal aorta and connecting to the right inferior pulmonary vein manifested as an incidental finding on a chest radiograph and was further evaluated on cross-sectional imaging in a young patient. Chest radiographs are non-specific and it is important to be aware of the less frequent but important pathologies that can be picked up on plain chest radiographs, which inturn should warrant further investigation. This is presented in conjunction with a review of the available literature along with a discussion regarding the differential diagnosis and management applicable to the general clinician.

  • radiology
  • heart failure
  • respiratory medicine

Statistics from Altmetric.com

Footnotes

  • Twitter @pjenkins200

  • Contributors PD supplied the cases. PJ wrote the manuscript and reviewed the cases. PD and RR reviewed the cases and edited 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.

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

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.