If a fistula is located close to the heart, what condition is the patient at increased risk for?

When a fistula is located close to the heart, the patient is at increased risk for cardiac failure due to the physiological effects that arise from the abnormal blood flow dynamics. A fistula creates a direct connection between a high-pressure arterial system and a low-pressure venous system, resulting in an increase in the overall blood volume returning to the heart. This increase in preload can lead to overstretching of the heart chambers and ultimately may cause the heart to work harder over time to pump the additional volume.

As the heart becomes unable to effectively manage this increased workload, it may begin to exhibit signs of heart failure, which can manifest as symptoms like fatigue, shortness of breath, and fluid retention. The proximity of the fistula to the heart can magnify these risks as the heart is immediately affected by the altered hemodynamics associated with the fistula. Thus, this condition places significant strain on the cardiac function, heightening the likelihood of developing heart failure.