High-output heart failure from AV fistula

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

Workup

  • Doppler ultrasound can accurately measure access flow rate and establish the diagnosis

Management

  • Surgical banding of the access

Disposition

  • Admit

See Also

External Links

References