A 45-Year-Old Woman With Hereditary Hemorrhagic Telangiectasia and Persistent Exertional Dyspnea and Peripheral Edema

We report the case of a 45-year-old woman who was referred to our Cardiology Department because of persistent exertional dyspnea and peripheral edema. She had an established clinical diagnosis of hereditary hemorrhagic telangiectasia with multiple gastrointestinal telangiectasias that had been submitted to repeat embolization in the past and arteriovenous malformations in the liver and lungs. Complete blood count was diagnostic for severe anemia (hemoglobin 5-6 g/dL). Since the hereditary hemorrhagic telangiectasia diagnosis 3 years prior, the patient informed us that she has undergone 27 blood transfusions and multiple embolizations to manage gastrointestinal telangiectasias. Given her severe anemia that was caused by gastrointestinal telangiectasia, treatment with bevacizumab was initiated. Bevacizumab was administered over 8 cycles (initially biweekly for 4 doses, followed by monthly administration).