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Hemothorax Due to Rupture of Pulmonary Arteriovenous Malformation: An Interventional Emergency

Adam M. Berg, MD; Smbat Amirbekian, BS; Hamid Mojibian, MD; Terence K. Trow, MD, FCCP; Steven J. Smith, MD; Robert I. White, Jr, MD
Author and Funding Information

Correspondence to: Robert I. White Jr, MD, Yale University School of Medicine, Department of Diagnostic Radiology, PO Box 208042, New Haven, CT 06520-8042; e-mail: bob.white@yale.edu


Funding/Support: Dr White was supported in part by the Josephine Lawrence Hopkins Foundation and the Nicole McConnell Foundation.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;137(3):705-707. doi:10.1378/chest.09-0344
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Spontaneous hemothorax as a result of a ruptured pulmonary arteriovenous malformation (PAVM) is a life-threatening event and requires immediate interventional therapy. We present two patients who survived following emergent embolization. Definitive thoracentesis was delayed until embolization was performed. The tamponade provided by the hemothorax may have prevented exsanguination, suggesting to us that drainage of blood from the pleural space should be delayed until the PAVM has been treated. Hemorrhage from a PAVM may be the first manifestation of hereditary hemorrhagic telangiectasia. Genetic testing and screening for other family members should be considered.

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