Presuming there is a carotid jugular fistula created by trauma at approximately the level where the common carotid separates......... could there be unequal external carotid pulses and diminished or absent internal carotid pulse on injured side? Would valves in the jugular be able to direct arterial blood flow into return tract without JVD on injured side? Possible increased inflow pressure to right ventricle cause dilation ? Given existing saphenous vein graft of RCA might dilation of RV affect lie of graft....nodal artery insufficiency.....bradycardia? Increasing demand on LV to compensate output?
I know. Tough to say... but possible?
Thanks for thoughtful answer....please.
Wow this is a very technical question requiring a LOT of thought, but at the same time interesting. For one thing, the answers to your questions would depend, and by substantially different, by the actual diameter of the fistular. If very small, I would suspect a patient would go for months or years before the correct diagnosis is found. However, if large, then this would be a totally different scenario. I think pulses would be felt on all vessels, but it would take an echo doppler to see the shunting. As you point out, there are valves involved on the venous side, and this would mean shunting of blood from the arterial side to venous would affect pressure into the right atrium. I think tachycardia would result and eventual cardiac failure would be imminent. The sooner the vessels are separated the better. There have been cases where medication has been attempted for heart failure with no benefits, but as soon as the fistula is closed off, the heart has recovered. Having given this a lot of thought, I can't help but wonder if the diastolic pressure would greatly decrease. I'm not a Doc or professional in medicine but I thank you for such an interesting question.
Copyright 1994-2016 MedHelp International. All rights reserved.
MedHelp is a division of Aptus Health.
This site complies with the HONcode standard for trustworthy health information.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.