Recurrent Gastrointestinal Bleeding in a Patient With Severe Aortic Valve Stenosis: A Diagnosis of Heyde’s Syndrome

Obeidat, Adham E; Kim, Jean

doi:10.7759/cureus.15442

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…Therefore, it can be difficult to definitively diagnose Heyde's syndrome, and cardiologists and gastroenterologists are required to comprehensively interpret a variety of patient symptoms and medical test results in order to make the diagnosis. Transcatheter aortic valve implantation (TAVI) can be expected to improve gastrointestinal bleeding associated with Heyde's syndrome [4][5][6]. Here, we present the case of an 82-year-old man with a history of severe AS who presented with iron deficiency anemia (IDA) and was found to have an atypical presentation of multifocal gastric bleeding cured by TAVI.…”

Section: Introductionmentioning

confidence: 99%

Disappearance of Atypical Gastric Mucosal Bleeding due to Heyde’s Syndrome after Transcatheter Aortic Valve Implantation

Sugimoto

Takamura

2022

Case Rep Gastroenterol

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An 82-year-old man was admitted to our hospital due to dyspnea on exertion. Blood tests showed iron deficiency anemia, and echocardiography revealed severe aortic stenosis (AS). Considering the possibility of Heyde’s syndrome, esophagogastroduodenoscopy was performed to confirm the presence or absence of gastrointestinal angiodysplasia. Endoscopy revealed multiple sites of mucosal bleeding in the stomach without angiodysplasia or mucosal erosion. Although it was an atypical endoscopic finding, we diagnosed gastric mucosal bleeding associated with Heyde’s syndrome. Since no atypical blood vessels could be found, endoscopic treatment was not performed, and only transcatheter aortic valve implantation (TAVI) for aortic valve stenosis was performed. TAVI immediately improved the dyspnea on exertion, and follow-up endoscopy 4 months after TAVI showed the disappearance of the multifocal mucosal bleeding in the stomach. Heyde’s syndrome is characterized by AS, acquired deficiency or dysfunction of von Willebrand factor, and gastrointestinal angiodysplasia; however, the exact diagnostic criteria have not been established. This is a case of mucosal bleeding due to Heyde’s syndrome, without the typical endoscopic image of angiodysplasia. Cardiologists and gastroenterologists need to consider the possibility of Heyde’s syndrome in AS patients with atypical gastrointestinal bleeding on endoscopy.

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Section: Introductionmentioning

confidence: 99%

Disappearance of Atypical Gastric Mucosal Bleeding due to Heyde’s Syndrome after Transcatheter Aortic Valve Implantation

Sugimoto

Takamura

2022

Case Rep Gastroenterol

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Transcatheter aortic valve implantation for patients with heyde syndrome: A literature review of case reports

Wang

et al. 2023

Heliyon

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Heyde’s syndrome: a systematic review of case reports

Saha

Wien

Fancher

et al. 2022

BMJ Open Gastroenterol

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ObjectiveHeyde’s syndrome (HS), a rare condition characterised by a unique relationship between severe aortic stenosis and angiodysplasia, is often diagnosed late increasing the risk for a prolonged hospital course and mortality in the elderly. The leading hypothesis explaining the aetiology of HS is acquired von Willebrand syndrome (AVWS) but not all studies support this claim. While individual cases of HS have been reported, here we present the first systematic review of case reports and focus on the prevalence of AVWS.DesignA systematic search was conducted through PubMed/MEDLINE, CINAHL-EBSCO, Web of Science and Google Scholar since inception. The resulting articles were screened by two independent reviewers based on inclusion criteria that the article must be a case report/series or a letter to the editor in English describing HS in an adult patient.ResultsSeventy-four articles encompassing 77 cases met the inclusion criteria. The average age was 74.3±9.3 years old with a slight female predominance. The small intestine, especially the jejunum, was the most common location for bleeding origin. Capsule endoscopy and double balloon enteroscopy were superior at identifying bleeding sources than colonoscopy (p=0.0027 and p=0.0095, respectively) and oesophagogastroduodenoscopy (p=0.0006 and p=0.0036, respectively). The mean duration from symptom onset to diagnosis/treatment of HS was 23.8±39 months. Only 27/77 cases provided evidence for AVWS. Surgical and transcutaneous aortic valve replacement (AVR) were superior at preventing rebleeding than non-AVR modalities (p<0.0001).ConclusionFurther research is warranted for a stronger understanding and increased awareness of HS, which may hasten diagnosis and optimal management.

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Recurrent Gastrointestinal Bleeding in a Patient With Severe Aortic Valve Stenosis: A Diagnosis of Heyde’s Syndrome

Cited by 3 publications

References 16 publications

Disappearance of Atypical Gastric Mucosal Bleeding due to Heyde’s Syndrome after Transcatheter Aortic Valve Implantation

Disappearance of Atypical Gastric Mucosal Bleeding due to Heyde’s Syndrome after Transcatheter Aortic Valve Implantation

Transcatheter aortic valve implantation for patients with heyde syndrome: A literature review of case reports

Heyde’s syndrome: a systematic review of case reports

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