Download PDF
Int J Angiol 2017; 26(02): 125-129
DOI: 10.1055/s-0035-1568878
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

High-Output Cardiac Failure Due to Hereditary Hemorrhagic Telangiectasia: A Case of an Extra-Cardiac Left to Right Shunt

Patrick R. Wu
1   Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, California
,
Amber Horwith
1   Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, California
,
Stephanie Mai
1   Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, California
,
Milind Parikh
1   Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, California
,
Gaurav Tyagi
2   Division of Cardiology, Loma Linda University Medical Center, Loma Linda, California
,
Ramdas G. Pai
2   Division of Cardiology, Loma Linda University Medical Center, Loma Linda, California
› Author Affiliations
Further Information

Publication History

Publication Date:
02 June 2016 (online)

    Permissions and Reprints

Abstract

High-output cardiac failure is a rare complication of hereditary hemorrhagic telangiectasia and can potentially be mistaken for other entities. We present a case of high-output cardiac failure because of large hepatic arteriovenous malformations, review the literature regarding the cardiac manifestations of the disease, and discuss the possible differential diagnoses.

Keywords

hereditary hemorrhagic telangiectasia - high-output cardiac failure - Osler-Weber-Rendu - arteriovenous malformation
 

  • References

  • 1 McDonald J, Pyeritz RE. Hereditary Hemorrhagic Telangiectasia. In: Pagon RA, et al., eds. GeneReviews(R) [Internet]. Seattle (WA): University of Washington, Seattle; 1993. –2017. Available from: https://www.ncbi.nlm.nih.gov/books/NBK1351/ . Accessed on April 28, 2017
    Google Scholar
  • 2 McDonald J, Bayrak-Toydemir P, Pyeritz RE. Hereditary hemorrhagic telangiectasia: an overview of diagnosis, management, and pathogenesis. Genet Med 2011; 13 (7) 607-616
    CrossrefPubMedGoogle Scholar
  • 3 McDonald J, Wooderchak-Donahue W, VanSant Webb C, Whitehead K, Stevenson DA, Bayrak-Toydemir P. Hereditary hemorrhagic telangiectasia: genetics and molecular diagnostics in a new era. Front Genet 2015; 6: 1-8
    PubMedGoogle Scholar
  • 4 Trotter JF, Suhocki PV, Lina JR, Martin LW, Parrish JL, Swantkowski T. Hereditary hemorrhagic telangiectasia causing high output cardiac failure: treatment with transcatheter embolization. Am J Gastroenterol 1998; 93 (9) 1569-1571
    CrossrefPubMedGoogle Scholar
  • 5 Ergun T, Lakadamyali H, Lakadamyali H, Eldem O. A case of high-output heart failure secondary to bilateral multiple pulmonary arterio-venous malformations treated with Amplatzer vascular plug. Anadolu Kardiyol Derg 2009; 9 (5) E17-E18
    PubMedGoogle Scholar
  • 6 Ginon I, Decullier E, Finet G , et al. Hereditary hemorrhagic telangiectasia, liver vascular malformations and cardiac consequences. Eur J Intern Med 2013; 24 (3) e35-e39
    PubMedGoogle Scholar
  • 7 Blum A, Shalabi R. Osler-Weber-Rendu (OWR) Disease and Heart Failure. Clin Med Cardiol 2009; 42: 861-865
    PubMedGoogle Scholar
  • 8 Cho D, Kim S, Kim M , et al. Two cases of high output heart failure caused by hereditary hemorrhagic telangiectasia. Korean Circ J 2012; 42 (12) 861-865
    CrossrefPubMedGoogle Scholar
  • 9 Khalid SK, Pershbacher J, Makan M, Barzilai B, Goodenberger D. Worsening of nose bleeding heralds high cardiac output state in hereditary hemorrhagic telangiectasia. Am J Med 2009; 122 (8) 779.e1-779.e9
    CrossrefPubMedGoogle Scholar
  • 10 Lin CP, Cheng JS, Lai KH, Lo GH, Pan HB. Recurrent gastrointestinal bleeding and high output cardiac failure caused by hereditary hemorrhagic telangiectasia. Zhonghua Yi Xue Za Zhi (Taipei) 2000; 63 (4) 339-343
    PubMedGoogle Scholar
  • 11 Koscielny A, Willinek WA, Hirner A, Wolff M. Treatment of high output cardiac failure by flow-adapted hepatic artery banding (FHAB) in patients with hereditary hemorrhagic telangiectasia. J Gastrointest Surg 2008; 12 (5) 872-876
    CrossrefPubMedGoogle Scholar
  • 12 Dupuis-Girod S, Ginon I, Saurin JC , et al. Bevacizumab in patients with hereditary hemorrhagic telangiectasia and severe hepatic vascular malformations and high cardiac output. JAMA 2012; 307 (9) 948-955
    PubMedGoogle Scholar
  • 13 Clayton T, Banks KP, Bui-Mansfield LT. AJR teaching file: high-output cardiac failure in a patient with a history of hereditary hemorrhagic telangiectasia. AJR Am J Roentgenol 2006; 187 (6, Suppl): S508-S510
    CrossrefPubMedGoogle Scholar
  • 14 Jaskolka J, Wu L, Chan RP, Faughnan ME. Imaging of hereditary hemorrhagic telangiectasia. AJR Am J Roentgenol 2004; 183 (2) 307-314
    CrossrefPubMedGoogle Scholar
  • 15 Mehta PA, Dubrey SW. High output heart failure. QJM 2009; 102 (4) 235-241
    CrossrefPubMedGoogle Scholar