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Haemoptysis: just another case of endocarditis? A case report

BACKGROUND : Pulmonary arteriovenous malformations (PAVM) are rare, and most cases are congenital. They require prompt recognition and management particularly in patients presenting with hypoxia and haemoptysis. We describe a unique case of recurrent endocarditis causing pulmonary artery aneurysms (...

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Autores principales: Huynh, Ronald, Morgan, Lucy, Yiannikas, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8274648/
https://www.ncbi.nlm.nih.gov/pubmed/34263124
http://dx.doi.org/10.1093/ehjcr/ytab226
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author Huynh, Ronald
Morgan, Lucy
Yiannikas, John
author_facet Huynh, Ronald
Morgan, Lucy
Yiannikas, John
author_sort Huynh, Ronald
collection PubMed
description BACKGROUND : Pulmonary arteriovenous malformations (PAVM) are rare, and most cases are congenital. They require prompt recognition and management particularly in patients presenting with hypoxia and haemoptysis. We describe a unique case of recurrent endocarditis causing pulmonary artery aneurysms (PAAs) and formation of PAVM. CASE SUMMARY : A 60-year-old woman presented with dyspnoea, haemoptysis, and severe hypoxia. Her background was significant for previous pacemaker lead infection, refractory heart failure secondary to severe tricuspid valve distortion by her pacemaker lead, tricuspid and mitral valve replacements complicated by recurrent endocarditis over several years. Two years prior to her current presentation computed tomography (CT) scanning revealed new small PAAs thought possibly to be mycotic in origin. After her current presentation, prompt high-resolution CT scanning of her chest with contrast revealed significant pulmonary haemorrhage and new clusters of PAVM. Urgent pulmonary angiography confirmed PAVM and was successfully treated with coil embolization. Her dyspnoea, pulmonary haemorrhage, and hypoxia resolved. DISCUSSION : Acquired causes account for a very small percentage of PAVM and the mechanism of their development is unknown. As she had recurrent right-sided endocarditis and her PAAs developed following this, with new PAVM developing 2 years later; we hypothesize that they were causally related. We believe this is the first case of recurrent left- and right-sided endocarditis leading to formation of PAAs and development of PAVM presenting with significant hypoxia and haemoptysis requiring prompt intervention.
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spelling pubmed-82746482021-07-13 Haemoptysis: just another case of endocarditis? A case report Huynh, Ronald Morgan, Lucy Yiannikas, John Eur Heart J Case Rep Case Report BACKGROUND : Pulmonary arteriovenous malformations (PAVM) are rare, and most cases are congenital. They require prompt recognition and management particularly in patients presenting with hypoxia and haemoptysis. We describe a unique case of recurrent endocarditis causing pulmonary artery aneurysms (PAAs) and formation of PAVM. CASE SUMMARY : A 60-year-old woman presented with dyspnoea, haemoptysis, and severe hypoxia. Her background was significant for previous pacemaker lead infection, refractory heart failure secondary to severe tricuspid valve distortion by her pacemaker lead, tricuspid and mitral valve replacements complicated by recurrent endocarditis over several years. Two years prior to her current presentation computed tomography (CT) scanning revealed new small PAAs thought possibly to be mycotic in origin. After her current presentation, prompt high-resolution CT scanning of her chest with contrast revealed significant pulmonary haemorrhage and new clusters of PAVM. Urgent pulmonary angiography confirmed PAVM and was successfully treated with coil embolization. Her dyspnoea, pulmonary haemorrhage, and hypoxia resolved. DISCUSSION : Acquired causes account for a very small percentage of PAVM and the mechanism of their development is unknown. As she had recurrent right-sided endocarditis and her PAAs developed following this, with new PAVM developing 2 years later; we hypothesize that they were causally related. We believe this is the first case of recurrent left- and right-sided endocarditis leading to formation of PAAs and development of PAVM presenting with significant hypoxia and haemoptysis requiring prompt intervention. Oxford University Press 2021-06-26 /pmc/articles/PMC8274648/ /pubmed/34263124 http://dx.doi.org/10.1093/ehjcr/ytab226 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Report
Huynh, Ronald
Morgan, Lucy
Yiannikas, John
Haemoptysis: just another case of endocarditis? A case report
title Haemoptysis: just another case of endocarditis? A case report
title_full Haemoptysis: just another case of endocarditis? A case report
title_fullStr Haemoptysis: just another case of endocarditis? A case report
title_full_unstemmed Haemoptysis: just another case of endocarditis? A case report
title_short Haemoptysis: just another case of endocarditis? A case report
title_sort haemoptysis: just another case of endocarditis? a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8274648/
https://www.ncbi.nlm.nih.gov/pubmed/34263124
http://dx.doi.org/10.1093/ehjcr/ytab226
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