Abstract
A 68-year-old female patient was admitted with the history of hereditary hemorrhagic telangiectasia （HHT）. She was diagnosed with pulmona ry arteriovenous malformations （PAVM） by the chest CT scan, and she was suffered from shortness of breath after local anesthesia with Xylocaine 2% with adrenalin 1:80,000 for the dental treatment at our hospital. Dental procedures were performed using Citanest-Octapressin Cartridge （prilocaine 3% with 0.054 IU Felypressin） to prevent shortness of breath. Reportedly, patients with HHT would also suffer from PAVM at the rate of about 50%. Moreover, the patients with HHT which merged with PAVM have cerebral infarction and a stroke prognosis rate of 9–41%. Not evaluating for PAVM in the dental treatments might cause a brain abscess, air embolization, and/or shortness of breath. As for the dental treatment, blood circulation mostly remains unaffected. However, this treatment sometimes affects the systemic circulation; thus, circulation control is necessary.
