Pulmonary Arteriovenous Malformation: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 2, 2026.
What kind of doctor treats Pulmonary Arteriovenous Malformation?
A pulmonologist, a doctor who specializes in lung conditions, usually manages PAVMs. Embolization is often done by an interventional radiologist, and many patients also see a genetic specialist if HHT is suspected. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What it is
A pulmonary arteriovenous malformation, often called a PAVM, is an abnormal connection between an artery and a vein inside the lung. Normally, blood picks up oxygen as it passes through tiny capillaries. With a PAVM, blood skips those vessels and flows straight from artery to vein, so less oxygen than normal reaches the body.
Symptoms
Some people with a PAVM have no symptoms at all and the problem is only found during testing for something else. When symptoms do happen, they often include shortness of breath and feeling tired. The skin or lips may look bluish, and coughing up blood needs medical attention right away.
Causes and who gets it
Most PAVMs are linked to a genetic condition called hereditary hemorrhagic telangiectasia, or HHT, which people are born with and which runs in families. Some PAVMs appear without any known cause. Risk can rise during pregnancy.
How doctors diagnose it
Doctors often start by checking oxygen levels with a small sensor on the finger, and a chest X-ray is a common first test. The main test is usually a CT scan, which shows the lung blood vessels clearly. Doctors may also ask about family history of HHT, nosebleeds, and small red spots on the lips.
Treatment
Not every PAVM needs treatment. Doctors consider the size of the malformation and whether it is causing symptoms. When treatment is needed, the most common option is embolization, in which a doctor plugs the abnormal vessel using a coil or plug placed through a thin tube. Some people need more than one procedure, and doctors usually recommend follow-up imaging over time.
When to see a doctor
Anyone who has ongoing shortness of breath, bluish lips or skin, or coughs up blood should see a doctor promptly. People with a family history of HHT should mention it, since screening can find PAVMs before they cause trouble.
How a direct primary care or concierge doctor fits in
A direct primary care doctor is paid a flat monthly fee, while a concierge doctor usually charges more and often works alongside insurance. Either type can order initial tests, check oxygen levels, and manage other health conditions. When a PAVM is suspected, they refer the patient to a specialist and stay involved by coordinating care over time.
Common questions
Is a pulmonary arteriovenous malformation cancer?
No, a PAVM is not cancer. It is a blood vessel problem, not a tumor. Still, it can cause health issues, so doctors monitor it closely.
Can a PAVM go away on its own?
PAVMs usually do not disappear without treatment. Doctors decide whether to treat based on size, symptoms, and other factors. Regular follow-up imaging is common either way.
Do all PAVMs mean I have HHT?
Most PAVMs are linked to HHT, but not all of them are. A doctor may suggest genetic testing or screening for HHT if a PAVM is found. Family history helps guide this decision.
Can I exercise with a PAVM?
Many people with a treated or small PAVM can be active, but this depends on the person. Doctors give advice based on oxygen levels and test results. Ask your doctor before starting a new exercise plan.
Sources
- MedlinePlus - Pulmonary arteriovenous fistula
- National Organization for Rare Disorders (NORD) - Vascular Malformations of the Brain
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
