Korean Circ J.  2012 Dec;42(12):861-865. 10.4070/kcj.2012.42.12.861.

Two Cases of High Output Heart Failure Caused by Hereditary Hemorrhagic Telangiectasia

• Cho D
• Kim S
• Kim M
• Seo YH
• Kim W
• Kang SH
• Park SM
• Shim W

• KMID: 1491105
• DOI: http://doi.org/10.4070/kcj.2012.42.12.861

Abstract

High-output cardiac failure is a rare complication of hereditary hemorrhagic telangiectasia (HHT) usually caused by shunting of blood through atriovenous malformations (AVMs) in the liver. We describe two cases of high output heart failure due to large hepatic AVMs. Clinical suspicion of HHT based on detailed history taking and physical examination is essential for early detection and proper management of heart failure associated with HHT.

Keyword

Heart failure; Telangiectasia, hereditary hemorrhagic

MeSH Terms

Heart
Heart Failure
Liver
Physical Examination
Telangiectasia, Hereditary Hemorrhagic

Figure

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  Fig. 1 Typical multiple telangiectasias on the tongue, finger tips and the cheek.

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  Fig. 2 Chest X-ray showing cardiomegaly and pulmonary congestion.

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  Fig. 3 Computed tomography scans of the abdomen with contrast and 3D reconstruction showing extensive intrahepatic collaterals with obliterated left portal vein and engorged hepatic artery of case 1 (A and B) and case 2 (C and D), respectively.

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  Fig. 4 Computed tomography scan of the thorax with contrast showing well-defined nodular lesions in the right middle lobe manifesting as an arteriovenous fistula (arrow).

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