- Case Report
- Open Access
Delayed bubble, coil and trouble: young stroke as a presentation of paradoxical embolism from previously unrecognised pulmonary arterio-venous malformation (PAVM)
Echo Research & Practice volume 7, pages K17–K20 (2020)
Young stroke patients should be investigated thoroughly to look for cardiac and extra-cardiac sources of emboli. We present a patient who was investigated for a cardiac source of emboli following an ischemic stroke. She was found to have a small patent foramen ovale (PFO), but due to the late appearances of bubbles on the bubble study it was thought that this was an incidental finding. Further investigation confirmed a PAVM was the source of emboli causing her stroke.
Kurshid I, Downie GH. Pulmonary arteriovenous malformation. Postgraduate Medical Journal 2002 78 191–197. (https://doi.org/10.1136/pmj.78.918.191)
Gossage JR, Kanj G. A state of the art review: pulmonary arteriovenous malformations. American Journal of Respiratory and Critical Care Medicine 1998 158 643–661. (https://doi.org/10.1164/ajrccm.158.2.9711041)
Hewes RC, Auster M, White RI Jr. Cerebral embolism-first manifestation of pulmonary arteriovenous malformation in patients with hereditary hemorrhagic telangiectasia. Cardiovascular and Interventional Radiology 1985 8 151–155. (https://doi.org/10.1007/BF02552883)
Kuhajda I, Milosevic M, Ilincic D, Kuhajda D, Pekovic S, Tsirgogianni K, Tsavlis D, Tsakiridis K, Sakkas A, Kantzeli A, et al. Pulmonary arteriovenous malformation-etiology, clinical four cae presentations and review of the literature. Annals of Translational Medicine 2015 3 171. (https://doi.org/10.3978/j.issn.2305-5839.2015.06.18)
Meek ME, Meek JC, Beheshti MV. Management of pulmonary arteriovenous malformations. Seminars in Interventional Radiology 2011 28 24–31. (https://doi.org/10.1055/s-0031-1273937)
This work did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.
Rights and permissions
This work is licensed under a Creative CommonsAttribution-NonCommercial-NoDerivatives 4.0 International License.(http://creativecommons.org/licenses/by/4.0/), which permits use, duplication, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.
About this article
Cite this article
Singh, T., Hinton, J., Swallow, R. et al. Delayed bubble, coil and trouble: young stroke as a presentation of paradoxical embolism from previously unrecognised pulmonary arterio-venous malformation (PAVM). Echo Res Pract 7, K17–K20 (2020). https://doi.org/10.1530/ERP-20-0001
- patent foramen ovale
- pulmonary arteriovenous malformation
- contrast echocardiography