Hereditary Hemorrhagic Telangiectasia Presenting as High Output Cardiac Failure during Pregnancy

Abstract

High‐output cardiac failure secondary to hepatic involvement is a rare complication of hereditary hemorrhagic telangiectasia (HHT). Here we report a 43‐year‐old woman who presented at 29 weeks gestation of her second pregnancy with complications of right‐sided heart failure and preterm labor. After delivery via cesarean section, the patient was found to have intrahepatic arteriovenous malformations through non‐invasive imaging. Subsequently, a family history of vascular malformations and epistaxis was elucidated and a diagnosis of HHT was made. This case is presented, along with a review of the literature and discussion of hepatic involvement in HHT with particular focus on the pregnant patient.