Bajraktari Gani, Rexhepaj Nehat, Bakalli Aurora, Shaqiri Gazmend, Osmani Eshref, Vokrri Lulzim, Elezi Shpend
Internal Medicine Clinic, University Clinical Centre, Prishtina, Kosovo.
Heart Surg Forum. 2005;8(2):E118-20. doi: 10.1532/hsf98.20041172.
We present a 15-year-old male patient who was admitted to our hospital because of breathlessness and palpitations at minimal physical effort (New York Heart Association class II). The patient had a history of an abdominal and left thigh firearm wound that was surgically treated 30 months earlier. Auscultation over the left femoral groin region revealed a systolodiastolic murmur. X-ray examination of the chest demonstrated significant cardiomegaly. Transthoracic echocardiography revealed an enlargement of 4 cardiac chambers, as well as significant mitral and tricuspid regurgitation. Vascular ultrasound of the femoral artery and vein confirmed the diagnosis of a traumatic arteriovenous fistula. The patient underwent surgical correction of the fistula, after which the symptoms subsided rapidly. Follow-up echocardiography performed 2 months after surgical repair showed a substantial reduction of cardiac size and a nearly complete absence of valvular regurgitations. This case highlights the importance of the recognition of arteriovenous fistulas as a cause of unexpected heart failure and demonstrates that the condition may improve substantially and rapidly after fistula correction.
我们报告一名15岁男性患者，因轻微体力活动时出现呼吸急促和心悸入院（纽约心脏协会II级）。该患者有腹部和左大腿火器伤史，30个月前接受了手术治疗。左腹股沟区听诊发现收缩期和舒张期杂音。胸部X线检查显示明显心脏扩大。经胸超声心动图显示4个心腔扩大，以及明显的二尖瓣和三尖瓣反流。股动脉和静脉血管超声证实了创伤性动静脉瘘的诊断。患者接受了瘘管手术矫正，术后症状迅速缓解。手术修复2个月后进行的超声心动图随访显示心脏大小显著减小，瓣膜反流几乎完全消失。本病例强调了认识动静脉瘘作为意外心力衰竭原因的重要性，并表明瘘管矫正后病情可能迅速且显著改善。
