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Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant genetic disease manifested by formation of telangiectasias and visceral vascular malformations of organ systems, including the skin, lungs, gastrointestinal tract, brain, and liver. Hepatic involvement may lead to portal hypertension, high-output cardiac failure, and biliary strictures.1 Diagnosis requires patients to have 3 of 4 clinical characteristics: epistaxis, telangiectasia on the skin, visceral lesions, and a first-degree relative with HHT.2 Management involves controlling the source of bleeding by packing the nasopharynx, endoscopic therapies, or pulmonary or hepatic embolization.3

Hereditary Hemorrhagic Telangiectasia With Liver Vascular Malformation Presenting With High-Output Heart Failure