Case Reports in Cardiology (Jan 2013)

Remote Stab Wound Resulting in AV Fistula and High-Output Heart Failure

  • Jennifer A. Rymer,
  • Lindsay L. Anderson,
  • J. Trevor Posenau,
  • W. Schuyler Jones

DOI
https://doi.org/10.1155/2013/902719
Journal volume & issue
Vol. 2013

Abstract

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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.