Korean Circ J.  1989 Mar;19(1):139-145. 10.4070/kcj.1989.19.1.139.

A Case of Congenital Arteriovenous Fistula at Left Subclavian Artery Accompanied by Notching on Superior Aspect of Rib

• Chung IM
• Cho SY
• Park SJ
• Lee WK
• Seo JS

• KMID: 1670383
• DOI: http://doi.org/10.4070/kcj.1989.19.1.139

Abstract

High output heart failure due to congenital arteriovenous fistula is a rare disease and is difficult to treat. A 27 year old man, suffering from dyspnea, palpitation, lower extremity edema, and abdominal distension admitted May, 1987. At admission there were continuous thrill and bruit at left supraclavicular and infraclavicular area. The heart sound was irregular and rapid, and grade IV/VI pansystolic murmur was audible at the apex. Chest PA showed marked cardiomegaly with pleural effusion and notching at superior aspect of left 2nd rib. Selective left subclavian artery angiogram showed extensive congenital arteriovenous fistula at the area of left subclavian artery and its branches. After setrial feeding artery embolization and palliative operation, the fistula size decreased much with clinical improvement.

Keyword

Congenital arteriovenous fistula; Rib notching

MeSH Terms

Adult
Arteries
Arteriovenous Fistula*
Cardiomegaly
Dyspnea
Edema
Fistula
Heart Failure
Heart Sounds
Humans
Lower Extremity
Pleural Effusion
Rare Diseases
Ribs*
Subclavian Artery*
Thorax