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January 1970

Pulmonary Arteriovenous Fistula.

Arch Intern Med. 1970;125(1):183. doi:10.1001/archinte.1970.00310010185037

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When one considers the price, $11.92, for a monograph on a relatively obscure but interesting subject, it may be of concern that the basic message in the book is covered in the first 49 pages (41% of the book length). A study of 27 patients with pulmonary arterial venous fistula (PAF) and a discussion of its interesting relationship to hereditary telangiectasia is a subject of great historical and eponymic interest, however. The clinical and laboratory analysis of these 36 individual instances makes up the remainder of the monograph.

Central themes come through: the classic features of dyspnea on exertion, clubbing, cyanosis, and polycythemia are really uncommon manifestations of the disease complex, the disease is only diagnosed if suspected, and the asymptomatic state is important and can be diagnosed readily with modern angiographic and blood gas determination techniques. The fact that the severity of disease relates to the degree of right-to-left

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