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[Arteriovenous fistula with cardiac insufficiency disclosing kidney cancer]
1Service de médecine interne A, CHU Bretonneau, Tours, France.
La Revue De Medecine Interne
|January 1, 1996
Insights
A kidney arteriovenous fistula caused severe heart failure in a 66-year-old woman. Surgical removal of the kidney tumor and fistula led to complete heart recovery.
Area of Science:
- Cardiology
- Nephrology
- Vascular Surgery
Background:
- Congestive heart failure (CHF) can arise from various underlying conditions.
- Rarely, arteriovenous fistulas can lead to high-output heart failure.
Observation:
- A 66-year-old woman presented with acute, severe congestive heart failure.
- She had no prior history of coronary or valvular heart disease.
- Angiography revealed an intraparenchymal arteriovenous fistula and kidney cancer in the left kidney.
Findings:
- The patient underwent nephrectomy to remove the kidney cancer and arteriovenous fistula.
- Post-surgery, hemodynamic assessment confirmed complete recovery of right ventricular function.
- Resolution of the arteriovenous fistula led to the reversal of heart failure symptoms.
Implications:
- This case highlights the importance of investigating uncommon causes of heart failure.
- Early diagnosis and intervention for renal arteriovenous fistulas can prevent severe cardiac complications.
- Nephrectomy can be a curative treatment for heart failure secondary to renal arteriovenous fistulas.
Abstract:
A 66 year-old woman free of any coronary and valvular heart disease presented to our hospital with acute and severe congestive heart failure associated with increased blood flow-angiography showed an intraparenchymatous arteriovenous fistula of the left kidney and a kidney cancer. The patient was discharged after nephrectomy and complete heart recovery as assessed from the normality of the hemodynamic exploration of the right ventricle.