A 44-year-old woman is described who developed palpitation and fatigue on minimal exertion following surgery to a lumbar disc. She had a continuous bruit localized to the left lower abdominal quadrant and minimal cardiomegaly. Diagnosis of arteriovenous fistula between the left internal iliac artery and the external iliac vein was confirmed by color flow and image-directed Doppler ultrasound and by digital subtraction angiography. Corrective surgery results in resolution of cardiomegaly.
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