High output heart failure 8 months after an acquired arteriovenous fistula.
Congestive heart failure (CHF) due to hyperkinetic states can occur in systemic diseases and in arteriovenous fistulas. An 18 year old Turkish male patient complaining of dyspnea and palpitations, who had suffered a stab wound to his abdomen eight months earlier, was admitted to our clinic. Auscultation revealed a systolodiastolic murmur over the entire abdomen. Chest x-rays demonstrated significant cardiomegaly. Echocardiography revealed biatrial enlargement and significant mitral and tricuspid regurgitation accompanied by dilatation of the inferior vena cava. Right heart catheterization showed increased oxygen saturation at the inferior vena cava. A diagnosis of an aortocaval fistula was made by aortography. The symptoms subsided and valvular regurgitations ceased alter surgical correction. This rare case demonstrates the significance of routine physical examination and history of the patient.
Department of Cardiology, School of Medicine, Gazi University, Ankara, Turkey.
Murtaza Emre
ME
Durakoglugil
Mehmet Gungor
MG
Kaya
Bulent
B
Boyaci
Atiye
A
Cengel
D000007:Abdominal Injuries / Q000150:complications; D000293:Adolescent; D001018:Aortic Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D001164:Arteriovenous Fistula / Q000150:complications* / Q000000981:diagnostic imaging; D016534:Cardiac Output, High / Q000209:etiology*; D006332:Cardiomegaly / Q000150:complications; D004452:Echocardiography; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000150:complications; D011859:Radiography; D014262:Tricuspid Valve Insufficiency / Q000150:complications; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D014951:Wounds, Stab / Q000150:complications