Remission of high-output heart failure after surgical repair of 30-month arteriovenous femoral fistula: case report.
We present a 15-year-old male patient who was admitted to our hospital because of breathlessness and palpitations at minimal physical effort (New York Heart Association class II). The patient had a history of an abdominal and left thigh firearm wound that was surgically treated 30 months earlier. Auscultation over the left femoral groin region revealed a systolodiastolic murmur. X-ray examination of the chest demonstrated significant cardiomegaly. Transthoracic echocardiography revealed an enlargement of 4 cardiac chambers, as well as significant mitral and tricuspid regurgitation. Vascular ultrasound of the femoral artery and vein confirmed the diagnosis of a traumatic arteriovenous fistula. The patient underwent surgical correction of the fistula, after which the symptoms subsided rapidly. Follow-up echocardiography performed 2 months after surgical repair showed a substantial reduction of cardiac size and a nearly complete absence of valvular regurgitations. This case highlights the importance of the recognition of arteriovenous fistulas as a cause of unexpected heart failure and demonstrates that the condition may improve substantially and rapidly after fistula correction.
Bajraktari
Gani
G
Internal Medicine Clinic, University Clinical Centre, Prishtina, Kosovo. ganibajraktari@yahoo.co.uk
Rexhepaj
Nehat
N
Bakalli
Aurora
A
Shaqiri
Gazmend
G
Osmani
Eshref
E
Vokrri
Lulzim
L
Elezi
Shpend
S
D000293:Adolescent; D001164:Arteriovenous Fistula / Q000150:complications* / Q000209:etiology* / Q000601:surgery; D016534:Cardiac Output, High / Q000209:etiology*; D006332:Cardiomegaly / Q000000981:diagnostic imaging / Q000209:etiology; D004452:Echocardiography; D005263:Femoral Artery; D005268:Femoral Vein; D006801:Humans; D008297:Male; D012074:Remission Induction; D013616:Tachycardia, Sinus / Q000000981:diagnostic imaging / Q000209:etiology; D014656:Vascular Surgical Procedures; D014948:Wounds, Gunshot / Q000150:complications*