Remote Stab Wound Resulting in AV Fistula and High-Output Heart Failure.
A 54-year-old African American male with no medical history presented to an urgent care clinic with signs and symptoms of new-onset congestive heart failure. There was an initial concern for congestive heart failure secondary to an ischemic etiology as an echocardiogram revealed a depressed ejection fraction. However, a left heart cardiac catheterization did not demonstrate any significant coronary disease. As a loud bruit was auscultated over the right base of the patient's neck, he underwent a carotid duplex ultrasound revealing a fistula between the right common carotid artery (CCA) and the right internal jugular vein (IJV). A diagnosis of high-output heart failure secondary to a large arteriovenous (AV) fistula was made, and the patient underwent ligation and repair of the fistula with resolution of symptoms of congestive heart failure.
Duke University Medical Center, Hospital North 7402, DUMC Box 3126, Durham, NC 27710, USA.
Jennifer A
JA
Rymer
Duke University Medical Center, Hospital North 7402, DUMC Box 3126, Durham, NC 27710, USA.
Lindsay L
LL
Anderson
Duke University Medical Center, Hospital North 7402, DUMC Box 3126, Durham, NC 27710, USA.
J Trevor
JT
Posenau
Duke University Medical Center, Hospital North 7402, DUMC Box 3126, Durham, NC 27710, USA.
W Schuyler
WS
Jones