Pulmonary arteriovenous malformations- Evidence of under recognition in respiratory medicine?

Abstract

Introduction: Pulmonary arteriovenous malformations (AVMs) affect ∼1 in 2,600 people and pose unique management challenges. Methods: US and UK Training curriculae were examined. PubMed searches were performed for “pulmonary arteriovenous malformations” or pulmonary arterial hypertension” with specified date ranges, with and without the filter ”case report”. Results: Pulmonary AVMs were not mentioned specifically within the current GMC Specialty training curriculum for respiratory medicine (UK) or ACGME Program Requirements for Graduate Medical Education in Pulmonary Disease (Internal Medicine, US). 3,604 publications were retrieved between 1946 and 2015. However, high proportions were single case reports, often reflecting common presentation patterns such as asymptomatic hypoxemia, pregnancy complications, or paradoxical embolic stroke. Since 1980, annual publications have risen three-fold. but the proportion of single case reports has also risen steadily. In contrast, pulmonary arterial hypertension (prevalence Conclusions: Publication patterns suggest continued under recognition of pulmonary PAVMs in mainstream respiratory medicine, favouring specific inclusion of this relatively common pulmonary vascular condition within Respiratory Medicine curricula.