Iatrogenic arteriovenous fistula causing pulmonal arterial hypertension and right heart failure

Arteriovenous fistula is a possible complication of diagnostic procedures requiring arterial femoral catheterization. Late onset manifestation is reported rarely. We describe an impressive case of severe pulmonary hypertension and consecutive right heart failure caused by an arteriovenous fistula of the iliacal artery and the inferior caval vein manifesting four years after cardiac catheterization.