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Heyde's syndrome: a review
Gordon E Pate1, Mann Chandavimol, Sheldon C Naiman
1Division of Cardiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
The Journal of Heart Valve Disease
|October 12, 2004
Summary
Heyde's syndrome links gastrointestinal bleeding from angiodysplasia to aortic stenosis (AS). Aortic valve replacement can resolve the acquired von Willebrand's disease causing this bleeding.
Area of Science:
- Gastroenterology
- Cardiology
- Hematology
Background:
- Heyde's syndrome describes gastrointestinal bleeding from angiodysplasia in patients with aortic stenosis (AS).
- Both aortic stenosis and intestinal angiodysplasia are chronic, age-related degenerative conditions often asymptomatic and underdiagnosed.
- Increasing evidence links severe AS to acquired Type 2 von Willebrand's disease, a bleeding disorder.
Purpose of the Study:
- To explore the relationship between aortic stenosis and gastrointestinal angiodysplasia.
- To understand the mechanism of bleeding in Heyde's syndrome.
- To evaluate treatment outcomes for Heyde's syndrome.
Main Methods:
- Review of existing literature on Heyde's syndrome, aortic stenosis, and intestinal angiodysplasia.
- Analysis of the proposed mechanism involving acquired von Willebrand's disease.
- Evaluation of treatment strategies including cauterization and aortic valve replacement.
Main Results:
- Severe AS can induce acquired Type 2 von Willebrand's disease, impairing hemostasis.
- This hematological defect exacerbates bleeding from intestinal angiodysplasia in Heyde's syndrome.
- Aortic valve replacement improves hematological abnormalities and clinical symptoms.
Conclusions:
- Heyde's syndrome results from acquired von Willebrand's disease associated with aortic stenosis.
- Aortic valve replacement offers the most promising long-term resolution for bleeding.
- Surgical intervention should be considered, especially for symptomatic AS patients.