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We present a case of an impressive PAVM presenting with chest pain, chronic cough, feelings of anxiety, mild resting hypoxemia and exertional hypoxemia. Of note, on previous chest X-ray, 8 years prior to presentation, an incidental mass was found during a shoulder repair presurgical workup but not further evaluated.<\/jats:p>","DOI":"10.1136\/bcr-2019-231981","type":"journal-article","created":{"date-parts":[[2019,10,23]],"date-time":"2019-10-23T15:36:37Z","timestamp":1571844997000},"page":"e231981","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Exertional hypoxia in a healthy adult: a pulmonary arteriovenous malformation"],"prefix":"10.1136","volume":"12","author":[{"given":"Kyle","family":"Keinath","sequence":"first","affiliation":[{"name":"Diagnostic Radiology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Vaughn","sequence":"additional","affiliation":[{"name":"Department of Medicine, BUMED, Falls Church, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Cole","sequence":"additional","affiliation":[{"name":"Department of Medicine, BUMED, Falls Church, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shari","family":"Gentry","sequence":"additional","affiliation":[{"name":"Department of Medicine, BUMED, Falls Church, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,10,23]]},"reference":[{"key":"2025082723071578000_12.10.e231981.1","article-title":"Multiple aneurysms of the pulmonary artery","volume":"1","author":"Churton","year":"1897","journal-title":"Br Med J"},{"key":"2025082723071578000_12.10.e231981.2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e31802f8da1"},{"key":"2025082723071578000_12.10.e231981.3","doi-asserted-by":"publisher","DOI":"10.1097\/01.RVI.0000191410.13974.B6"},{"key":"2025082723071578000_12.10.e231981.4","doi-asserted-by":"publisher","DOI":"10.1097\/01.RVI.0000126811.05229.B6"},{"key":"2025082723071578000_12.10.e231981.5","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2007.087452"},{"key":"2025082723071578000_12.10.e231981.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.arbres.2013.08.006"},{"key":"2025082723071578000_12.10.e231981.7","doi-asserted-by":"publisher","DOI":"10.4065\/74.7.671"},{"key":"2025082723071578000_12.10.e231981.8","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00075110"},{"key":"2025082723071578000_12.10.e231981.9","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/j.rmed.2015.04.003","article-title":"Prevalence and nature of dyspnea in patients with hereditary hemorrhagic telangiectasia (HHT)","volume":"109","author":"Rozenberg","year":"2015","journal-title":"Respir Med"},{"key":"2025082723071578000_12.10.e231981.10","unstructured":"SLOAN RD . 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