High Out-Put Congestive Heart Failure as First Manifestation of Osler-Weber-Rendu Disease M. Montejo Baranda, M.D., F.I.C.a., M. Perez, M.D.,* J. De Andres, M.D.,* C. De La Hoz, M.D., J. Merino, M.D., and C. Aguirre, M.D. Bilbao, Spain

Abstract

We present two cases of hemorrhagic hereditary telangiectasia (HHT) or Osler-Weber-Rendu disease which started as heart failure. Both had multiple arteriovenous fistulas, one of them in a rare localization in this disease, a lower extremity. We conclude stressing the importance of thinking of HHT in the presence of obscure heart failure or arteriovenous fistulas and of looking for internal fistulas when faced by a HHT.

Combination treatment with an erythropoiesis-stimulating agent and intravenous iron alleviates anaemia in patients with hereditary haemorrhagic telangiectasia

“…iron in these patients is that their anaemia is caused by a combination of recurrent haemorrhage and anaemia of chronic disease ( 20 ), since all four patients suffered from concomitant illnesses. Two of the patients were diagnosed with congestive heart failure (CHF) secondary to high-output heart failure associated with HHT ( 21,22 ), and the other two with chronic arthritis and chronic obstructive pulmonary disease (COPD) with frequent exacerbations, respectively. Anaemia is common in CHF and chronic arthritis, and responds well to ESA treatment ( 9-12,23 ).…”

Deficiency in hereditary hemorrhagic telangiectasia-associated Endoglin elicits hypoxia-driven heart failure in zebrafish

“…Congestive heart failure, although uncommon, constitutes another critical clinical manifestation of HHT. Cases are mainly associated with liver AVMs and chronic anemia of iron-deficiency type ( Cho et al, 2012 ; Goussous et al, 2009 ; Montejo Baranda et al, 1984 ; Wu et al, 2017 ).…”