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</div><div><span>Pulmonary arteriovenous fistula</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Pulmonary arteriovenous fistula</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Pulmonary arteriovenous fistula is an abnormal connection between an artery and vein in the lungs. As a result, blood passes through the lungs without receiving enough oxygen.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>Pulmonary arteriovenous fistulas are usually the result of abnormal development of the blood vessels of the lung. Most occur in people with <a test="test" href="./000837.htm">hereditary hemorrhagic telangiectasia (HHT)</a>. These people often have abnormal blood vessels in many other parts of the body.</p><p>Fistulas also can be a complication of liver disease or lung injury, although these causes are much less common.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Many people have no symptoms. When symptoms occur, they can include:</p><ul><li><a test="test" href="./003073.htm">Bloody sputum</a></li><li><a test="test" href="./003075.htm">Difficulty breathing</a></li><li>
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Difficulty exercising
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</li><li>
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Nosebleeds
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</li><li>Shortness of breath with exertion</li><li><a test="test" href="./003079.htm">Chest pain</a> </li><li>Blue skin (<a test="test" href="./003215.htm">cyanosis</a>)</li><li><a test="test" href="./003282.htm">Clubbing</a> of the fingers</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>The health care provider will examine you. The exam may show:</p><ul><li>Abnormal blood vessels (<a test="test" href="./003284.htm">telangiectasias</a>) on the skin or mucous membranes</li><li>Abnormal sound, called a murmur when a stethoscope is placed over the abnormal blood vessel</li><li>Low oxygen when measured with a pulse oximeter</li></ul><p>Tests that may be done include:</p><ul><li><a test="test" href="./003855.htm">Arterial blood gas</a>, with and without oxygen (usually oxygen treatment does not improve the arterial blood gas as much as expected) </li><li><a test="test" href="./003642.htm">Complete blood count</a> (CBC)</li><li><a test="test" href="./003804.htm">Chest x-ray</a></li><li><a test="test" href="./003788.htm">Chest CT scan</a></li><li><a test="test" href="./003869.htm">Echocardiogram</a> with bubble study to check the function of the heart and assess for presence of a shunt</li><li><a test="test" href="./003853.htm">Lung function tests</a></li><li><a test="test" href="./003828.htm">Perfusion radionuclide lung scan</a> to measure breathing and circulation (perfusion) in all areas of the lungs</li><li>Pulmonary <a test="test" href="./003327.htm">arteriogram</a> to view the lung arteries</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>A small number of people who have no symptoms may not need treatment. For most people with fistulas, the treatment of choice is to block the fistula during an <a test="test" href="./003327.htm">arteriogram</a> (embolization).</p><p>Some people may need surgery to remove the abnormal vessels and nearby lung tissue.</p><p>When arteriovenous fistulas are caused by liver disease, the treatment is a <a test="test" href="./003006.htm">liver transplant</a>.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>The outlook for people with HHT is not as good as for those without HHT. For people without HHT, surgery to remove the abnormal vessels usually has a good outcome, and the condition is not likely to return.</p><p>For people with liver disease as a cause, prognosis depends on liver disease.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Complications may include:</p><ul><li><div>
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Bleeding in the lung
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</div></li><li><div><div><a test="test" href="./000726.htm">Stroke</a> due to blood clot that travels from the lungs to the arms, legs, or brain (paradoxical venous embolism)</div></div></li><li><div>Infection in the brain or heart valve, especially in patients with HHT</div></li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Contact your provider if you often have nosebleeds or difficulty breathing, especially if you also have a personal or family history of HHT.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-8" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-8"><p>Because HHT is often genetic, prevention is not usually possible. <a test="test" href="../patientinstructions/000510.htm">Genetic counseling</a> may help in some cases.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Arteriovenous malformation - pulmonary</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Prabhudesai V, Faughnan ME. Pulmonary vascular anomalies. In: Broaddus VC, Ernst JD, King TE, et al, eds. <em>Murray and Nadel's Textbook of Respiratory Medicine</em>. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 88.</p><p>Stowell J, Gilman MD, Walker CM. Congenital thoracic malformations. In: Shepard JO, ed. <em>Thoracic Imaging: The Requisites</em>. 3rd ed. Philadelphia, PA: Elsevier; 2019:chap 8.</p><p>Valente AM, Dorfman AL, Babu-Narayan SV, Krieger EV. Congenital heart disease in the adolescent and adult. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. <em>Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine</em>. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 82.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 7/31/2022</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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