Pulmonary arteriovenous malformations with deep vein thrombosis and hypoxemia after delivery as a differential diagnosis of pulmonary embolism: A case report

Abstract

Pulmonary arteriovenous malformation (PAVMs) is a rare condition characterized by abnormal vascular connections between pulmonary arteries and veins. Increased pulmonary blood flow during pregnancy can exacerbate intrapulmonary shunt, which can cause stroke or pulmonary hemorrhage and lead to maternal death, miscarriage, and fetal growth restriction. PAVMs may be misdiagnosed, as their prominent symptoms are similar to those of pulmonary embolism (PE). We report herein a case of a 20-year-old woman diagnosed with PAVMs, who was initially suspected to have PE. She developed hypoxemia and deep vein thrombosis immediately after delivery that resulted in fetal growth restriction and asymptomatic acute cerebral infarction. Undiagnosed chronic hypoxemia was considered as a differential diagnosis of PE, since the patient showed signs of chronic hypoxia such as clubbing and cyanosis. Our findings underscore the importance of thorough systemic assessment during the first visit of patients with suspected PE.