Leg oedema and exertional dyspnea due to aortocaval fistula complicating an abdominal aortic aneurysm

Aortocaval fistula (ACF) represents a rare complication of abdominal aortic aneurysm (AAA) that may lead to hyperdynamic heart failure. We briefly describe a 58-year-old man with an old myocardial infarction, who developed leg oedema and worsening exertional dyspnea due to ACF complicating an AAA. This uncommon case highlights that an appropriate investigation for AAA and ACF should be performed in high-risk patients presenting with a history of worsening leg oedema and dyspnea in the absence of an obvious precipitating factor.