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Aortic Valve Replacement for the Management of Heyde Syndrome: A Case Report.
J Nippon Med Sch 2017; 84(4):193-197JN

Abstract

Heyde syndrome describes the triad of aortic stenosis, acquired coagulopathy, and anemia due to bleeding from intestinal angiodysplasia. An 87-year-old man with iron deficiency anemia due to melena was admitted to our hospital. On examination, a systolic murmur was heard and echocardiography confirmed the presence of aortic stenosis. Esophagogastroduodenoscopy and colonoscopy were unremarkable. Capsule endoscopy and double balloon endoscopy revealed angiodysplasia throughout the small intestine. Laboratory investigations were significant for reduced plasma levels of high molecular weight von Willebrand factor multimers. On the basis of these findings, the patient was diagnosed with Heyde syndrome. The patient required frequent blood transfusions because of the intestinal bleeding, and underwent bioprosthetic aortic valve replacement. Twenty months after the operation, the gastrointestinal bleeding resolved and the patient no longer required blood transfusions. This is the first case report to describe an improvement in bleeding from angiodysplasia, one year after aortic valve replacement. It demonstrates the effective treatment of Heyde syndrome with aortic valve replacement, and highlights the importance of considering this differential diagnosis when evaluating patients presenting with repeated episodes of gastrointestinal bleeding and a concurrent systolic murmur.

Authors+Show Affiliations

Third Department of Internal Medicine, Nara Medical University.Third Department of Internal Medicine, Nara Medical University.Third Department of Internal Medicine, Nara Medical University.Third Department of Internal Medicine, Nara Medical University.Third Department of Internal Medicine, Nara Medical University.Third Department of Internal Medicine, Nara Medical University.Third Department of Internal Medicine, Nara Medical University.Third Department of Internal Medicine, Nara Medical University.Third Department of Internal Medicine, Nara Medical University.Third Department of Internal Medicine, Nara Medical University.Third Department of Internal Medicine, Nara Medical University.Third Department of Internal Medicine, Nara Medical University.Third Department of Internal Medicine, Nara Medical University.Third Department of Internal Medicine, Nara Medical University.Department of Endoscopy, Nara Medical University.Third Department of Internal Medicine, Nara Medical University.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

28978901

Citation

Shibamoto, Akihiko, et al. "Aortic Valve Replacement for the Management of Heyde Syndrome: a Case Report." Journal of Nippon Medical School = Nippon Ika Daigaku Zasshi, vol. 84, no. 4, 2017, pp. 193-197.
Shibamoto A, Kawaratani H, Kubo T, et al. Aortic Valve Replacement for the Management of Heyde Syndrome: A Case Report. J Nippon Med Sch. 2017;84(4):193-197.
Shibamoto, A., Kawaratani, H., Kubo, T., Nishimura, N., Sato, S., Seki, K., ... Yoshiji, H. (2017). Aortic Valve Replacement for the Management of Heyde Syndrome: A Case Report. Journal of Nippon Medical School = Nippon Ika Daigaku Zasshi, 84(4), pp. 193-197. doi:10.1272/jnms.84.193.
Shibamoto A, et al. Aortic Valve Replacement for the Management of Heyde Syndrome: a Case Report. J Nippon Med Sch. 2017;84(4):193-197. PubMed PMID: 28978901.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aortic Valve Replacement for the Management of Heyde Syndrome: A Case Report. AU - Shibamoto,Akihiko, AU - Kawaratani,Hideto, AU - Kubo,Takuya, AU - Nishimura,Norihisa, AU - Sato,Shinya, AU - Seki,Kenichiro, AU - Sawada,Yasuhiko, AU - Takaya,Hiroaki, AU - Okura,Yasushi, AU - Takeda,Kousuke, AU - Uejima,Masakazu, AU - Namisaki,Tadashi, AU - Moriya,Kei, AU - Mitoro,Akira, AU - Yamao,Junichi, AU - Yoshiji,Hitoshi, PY - 2017/10/6/entrez PY - 2017/10/6/pubmed PY - 2018/2/15/medline KW - Heyde syndrome KW - acquired von Willebrand's syndrome KW - aortic stenosis KW - gastrointestinal bleeding SP - 193 EP - 197 JF - Journal of Nippon Medical School = Nippon Ika Daigaku zasshi JO - J Nippon Med Sch VL - 84 IS - 4 N2 - Heyde syndrome describes the triad of aortic stenosis, acquired coagulopathy, and anemia due to bleeding from intestinal angiodysplasia. An 87-year-old man with iron deficiency anemia due to melena was admitted to our hospital. On examination, a systolic murmur was heard and echocardiography confirmed the presence of aortic stenosis. Esophagogastroduodenoscopy and colonoscopy were unremarkable. Capsule endoscopy and double balloon endoscopy revealed angiodysplasia throughout the small intestine. Laboratory investigations were significant for reduced plasma levels of high molecular weight von Willebrand factor multimers. On the basis of these findings, the patient was diagnosed with Heyde syndrome. The patient required frequent blood transfusions because of the intestinal bleeding, and underwent bioprosthetic aortic valve replacement. Twenty months after the operation, the gastrointestinal bleeding resolved and the patient no longer required blood transfusions. This is the first case report to describe an improvement in bleeding from angiodysplasia, one year after aortic valve replacement. It demonstrates the effective treatment of Heyde syndrome with aortic valve replacement, and highlights the importance of considering this differential diagnosis when evaluating patients presenting with repeated episodes of gastrointestinal bleeding and a concurrent systolic murmur. SN - 1347-3409 UR - https://www.unboundmedicine.com/medline/citation/28978901/Aortic_Valve_Replacement_for_the_Management_of_Heyde_Syndrome:_A_Case_Report_ L2 - https://dx.doi.org/10.1272/jnms.84.193 DB - PRIME DP - Unbound Medicine ER -