A 50 year-old male is being evaluated due to exertional dyspnea. He is a known case of chronic kidney failure which receives hemodialysis 3 times weekly. Chest x-ray reveals cardiomegaly and pulmonary congestion. Further evaluation determines that hir symptoms are likely due to persistence of the arteriovenous fistula that is used for hemodialysis. Which of the following physiologic changes are most likely present in this patient due to the fistula?

Question

A 50 year-old male is being evaluated due to exertional dyspnea. He is a known case of chronic kidney failure which receives hemodialysis 3 times weekly. Chest x-ray reveals cardiomegaly and pulmonary congestion.  Further evaluation determines that hir symptoms are likely due to persistence of the arteriovenous fistula that is used for hemodialysis.  Which of the following physiologic changes are most likely present in this patient due to the fistula?

Quizplus · Accepted Answer

Eductional Objective: In patient with large arteriovenous fistula causes a decrease in the systemic vascular resistance which leads to increase venous return and increase cardiac output which finally leads to high- output heart failure. Despite a sustained increase in cardiac output, the left ventricle is unable to keep up with the increased venous return, and decompensated heart failure develop

A 50 Year-Old Male Is Being Evaluated Due to Exertional