case_images: PMC11812074_01
case_images: Chest radiography shows mild pulmonary edema. R, right; AP, anteroposterior.
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case_images: Chest radiography revealed mild pulmonary edema (Fig. 1).
case_images: Electrocardiography demonstrates a junctional rhythm with ST-segment elevation in the inferior leads (II, III, aVF). aVR, augmented vector right; aVL, augmented vector left; aVF, augmented vector foot.
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case_images: Electrocardiography demonstrated junctional rhythm with ST-segment elevation in the inferior leads (Fig. 2).
case_images: Saline contrast echocardiography demonstrates agitated saline bubbles in the left ventricle, consistent with an extracardiac shunt (observed at zero, three, six, and nine cardiac beats).
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case_images: Bedside TTE with a saline contrast test was performed to evaluate possible shunting, with appearance in the left atrium after six beats and complete opacification of the left ventricular endocardium after nine beats, consistent with a significant extracardiac shunt (Fig. 3).
case_images: Contrast-enhanced thoracic computed tomography reveals a 3.5-mm pulmonary arteriovenous malformation in the left lower lobe (arrow).
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case_images: Subsequent chest computed tomography (CT) confirmed the presence of a large pulmonary AVM in the left lower lobe (Fig. 4).