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Document Type

Case Report

Abstract

There are many causes of high-output cardiac failure. We present a unique case of high-output cardiac failure caused by multiple coronary-to-pulmonary artery (PA) fistulas, which, to our knowledge, is a rare finding that has not been previously researched. The purpose of our case report is to highlight the importance of considering coronary-to-PA fistulas in the differential diagnosis of patients presenting with high-output cardiac failure. Our patient presented to the emergency department with shortness of breath and underwent nuclear stress testing, which, through cardiac catheterization, revealed coronary-to-PA fistulas as the cause of the high-output cardiac failure. These fistulas were successfully treated with two-stage coil embolization. Significant improvement in the patient’s Fick cardiac output, from 8.89 L/min to 6.4 L/min, and a decrease in the PA pressure, from 28/6 mm Hg to 20/11 mm Hg, indicated that the cause of the patient’s symptoms was the fistulas. The patient’s complex fistulas were also successfully treated with coiling, showcasing the advancements in percutaneous techniques. Although it is uncommon, high-output cardiac failure caused by multiple coronary-to-PA fistulas underscores the importance of considering this diagnosis when evaluating similar patients.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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