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Systemic arteriovenous fistula simulating severe valvular aortic stenosis.
Chest
|July 1, 1976
Summary
A renal arteriovenous fistula mimicked aortic stenosis, causing heart failure symptoms. Surgical closure of the fistula completely resolved the patient's symptoms and heart murmur.
Area of Science:
- Cardiovascular Medicine
- Interventional Radiology
Background:
- Renal arteriovenous fistulas can present with complex cardiovascular symptoms.
- Differentiating fistulas from valvular heart disease is crucial for accurate diagnosis and treatment.
Observation:
- A patient presented with symptoms of congestive heart failure and syncope.
- A harsh systolic murmur and thrill in the aortic area suggested valvular aortic stenosis, possibly due to rheumatic fever history.
Findings:
- Cardiac catheterization identified a significant left-to-right shunt (8.7 L/min) originating from a renal arteriovenous fistula.
- The fistula was the underlying cause of the patient's cardiovascular symptoms.
Implications:
- Successful surgical ligation of the renal arteriovenous fistula led to complete symptom resolution.
- This case highlights the importance of considering vascular anomalies in the differential diagnosis of heart failure and murmurs.