Aorto-Atrial Fistula Case Report with Discussion on Gerbode Defect.

This case report describes a 62-year-old female with a history of heart failure with preserved ejection fraction (HFpEF) who presented to the emergency department with heart failure exacerbation. She was initially diagnosed with bilateral pleural effusions and treated with thoracentesis and diuretics. When follow-up indicated a lack of improvement, an ischemic workup was ordered. A transesophageal echocardiogram (TEE) revealed an abnormal connection between the right atrium and proximal aorta (aorto-atrial fistula), which was promptly fixed with surgical patching. This report also discusses the Gerbode defect, an abnormal congenital or acquired connection between the left ventricle and right atrium. Both conditions can significantly impact patients undergoing anesthesia. Further research on these abnormalities is essential to prevent poor outcomes.