High Output Cardiac Failure Caused by Multiple Giant Cutaneous Hemangiomas

A 59-year-old Chinese woman had multiple giant cutaneous cavernous hemangiomas on her right upper limb which resulted in high output heart failure because they presented as a large peripheral arteriovenous (A-V) fistula. Selective right subclavian arteriography showed extremely hypertrophic arteries of the patient's right arm with a tremendous blood supply to the soft tissues; neither superselective embolization nor surgery seemed applicable to this patient. The patient's heart failure was not satisfactorily controlled by conservative treatment.