Abstract
Background: Pulmonary arteriovenous malformations (PAVMs) generate a right to left shunt. Hypoxaemia is common, but dyspnoea is usually not the presenting complaint.
Methods: To identify factors contributing to dyspnoea, a retrospective analysis was performed in 165 consecutive patients presenting with CT-proven PAVMs between 2005-10. Based on reported exercise tolerance at presentation, and blinded to physiological measurements, two investigators assigned patients to the Medical Research Council dyspnoea scale, with individuals undertaking regular/intense sport reclassified as Grade “0”.
Results: 44 (27%) patients were dyspnoeic (24% excluding the 5 with severe coexistent respiratory disease). In univariate analyses, oxygen saturations (SpO2), displayed no clear relationship with dyspnoea grade (Fig. 1, left). Patient ages ranged from 17-87 years however, and older patients were more dyspnoeic (Fig. 1, right)
Once adjusted for age, there was a contribution of SpO2 to dyspnoea grade, although age and SpO2 did not account for most of the variation (r2=19%).
Conclusions: It is unusual for PAVMs alone to account for moderate to severe dyspnoea.
- © 2011 ERS