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High-output heart failure from AV fistula
From WikEM
Contents
Background
- Occurs when >20% of cardiac output is diverted through the access
Clinical Features
- Branham sign (drop in HR after temporary access occlusion) is diagnostic
Differential Diagnosis
AV Fistula Complications
- Clotting of AV fistula
- Infection of AV fistula
- Hemorrhage of AV fistula
- Vascular insufficiency from AV fistula
- AV fistula aneurysm/pseudoaneurysm
- High-output heart failure from AV fistula
Workup
- Doppler ultrasound can accurately measure access flow rate and establish the diagnosis
Management
- Surgical banding of the access
Disposition
- Admit
