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A lung biopsy was ultimately performed and histopathology revealed diffuse microvascular pulmonary arteriovenous malformations. This is one of few cases reported of this rare vascular abnormality and highlights its strong genetic association with hereditary haemorrhagic telangiectasia. The diagnostic challenges and management of this unique condition are reviewed in detail.<\/jats:p>","DOI":"10.1136\/bcr-2015-211975","type":"journal-article","created":{"date-parts":[[2015,9,26]],"date-time":"2015-09-26T06:27:28Z","timestamp":1443248848000},"page":"bcr2015211975","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["A 58-year-old woman with hypoxia, hypoxaemia, a hole in the heart and a \u2026 herring! Intracardiac or extracardiac shunt? 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