A 44-year-old woman is described who developed palpitation and fatigue
on minimal exertion following surgery to a lumbar disc. She had a con
tinuous bruit localized to the left lower abdominal quadrant and minim
al cardiomegaly. Diagnosis of arteriovenous fistula between the left i
nternal iliac artery and the external iliac vein was confirmed by colo
r flow and image-directed Doppler ultrasound and by digital subtractio
n angiography. Corrective surgery results in resolution of cardiomegal
y.