Abstract

SENIOR, Juan M  and  CHAVARRIAGA, Juan C. High output cardiac failure by systemic arteriovenous fistulas in a patient with Osler-Weber-Rendu syndrome. Rev. Colomb. Cardiol. [online]. 2013, vol.20, n.5, pp.309-315. ISSN 0120-5633.

We report the case of a 65 year old patient with history of recurrent epistaxis without other significant medical history, who presented symptoms of progressive dyspnea, from exertional dyspnea to dyspnea at rest, orthopnea and edema that began in lower limbs and progressed to anasarca. Clinical examination showed jugular ingurgitation, hepatomegaly, ascites and peripheral edema. Skin telangiectasiae were found in extremities and mucosae. Studies performed reported heart failure with severe dilatation of the right cavities with left ventricular systolic function preserved. Arteriovenous fistulas were demonstrated in liver and lung. A diagnosis of Osler-Weber-Rendu syndrome or hereditary hemorrhagic telangiectasia (HHT)was established. Percutaneous closure of fistulas was proposed and a possible liver transplantation was considered as a treatment, but the patient had a torpid evolution, presented atrial fibrillation and embolism to the central nervous system and died from cerebrovascular disease.

Keywords : fistula; heart failure; short; spending cardiac catheterization.

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