Aortic stenosis and angiodysplastic gastrointestinal bleeding: Heyde's disease

Heart Lung. Jan-Feb 2012;41(1):90-4. doi: 10.1016/j.hrtlng.2010.07.004. Epub 2011 Oct 11.

Abstract

Obscure gastrointestinal (GI) bleeding can be a perplexing and difficult problem in elderly patients, especially if they are hemodynamically unstable. If aortic stenosis is also present, the cause of the GI bleeding may be explained. We present a 66-year-old man with a medical history of coronary artery disease who presented with acute GI bleeding. During his hospital course, the patient had a colonoscopy showing diffuse angiodysplasia and an echocardiogram showing severe aortic stenosis. This combination of angiodysplasia and aortic stenosis is known as Heyde's syndrome. It has been hypothesized that the aortic stenosis causes an acquired von Willebrand factor deficiency that leads to GI bleeding. Aortic valve replacement, when possible, can prevent recurrent GI bleeding in these cases, but medical decisions in these cases are complex and difficult.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angiodysplasia / diagnosis
  • Angiodysplasia / etiology
  • Angiodysplasia / pathology*
  • Aortic Valve Stenosis / complications
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / pathology*
  • Colonoscopy / adverse effects
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / pathology*
  • Humans
  • Male
  • von Willebrand Diseases

Supplementary concepts

  • Von willebrand factor, deficiency