The Diagnostic Dilemma of Heyde Syndrome: A Case Report

Authors

  • Rija Sohail Dept. of Physiology, Northwest School of Medicine, Peshawar
  • Hamd E Yazdaan Department of Medicine-Khyber Teaching Hospital, Peshawar
  • Arfaa Hoor Khyber Medical College, Peshawar

Keywords:

Heyde, Dieulafoy Lesion, Cardiology, Gastroenterology

Abstract

Heyde syndrome is a multisystem disorder characterized by the triad of aortic stenosis (AS), gastrointestinal bleeding, and acquired von Willebrand syndrome. We present the case of an 80 years old male that presented to us with a recurrent gastrointestinal bleed and syncope. Upon investigation it was found that the patient has clinically severe AS. On physical examination he had a grade 4/6 systolic murmur at the second right intercostal space radiating toward the right carotid artery. An upper GI endoscopy was planned which reported proximal jejunal AVM consistent with a Dieulafoy lesion. The history of lower gastrointestinal bleeding (angiodysplasia) and the presence of aortic stenosis were consistent with Heyde syndrome. Given the patient’s age and a high EuroSCORE, the patient was referred for transcatheter aortic valve implantation. The procedure was uneventful and the patient was discharged once stable. The patient did not experience gastrointestinal bleeding in the periprocedural period.

References

Heyde EC. Gastrointestinal bleeding in aortic stenosis. N Engl J Med. 1958; 259: 196.

Mishra PK et al. Intestinal angiodysplasia and aortic valve stenosis: lets not close the book on this association. European Journal of Cardiothoracic Surgery 2009; 35: 628-34.

King RM, Pluth JR, Guiliani ER. The association of unexplained gastrointestinal bleeding with calcific aortic stenosis. Ann Thorac Surg 1987; 44: 514-6.

Tsai HM. Shear stress and von Willebrand factor in health and disease. Semin Thromb Hemost 2003;29:479-488.

Vincentelli A, Susen S, Le Tourneau T et al. Acquired von Willebrand syndrome in aortic stenosis. N Engl J Med 2003;349:343-9.

Pate GE, Chandavimol M, Naiman SC, et al. Heyde’s syndrome: a review. J Heart Valve Dis 2004;13:701–12

Warkentin TE, Moore JC, Anand SS, et al. Gastrointestinal bleeding, angiodysplasia, cardiovascular disease, and acquired von Willebrand syndrome. Transfus Med Rev 2003;17:272–86

Islam S, Cevik C, Islam E, et al. Heyde’s syndrome: a critical review of the literature. J Heart Valve Dis 2011;20:366–75

Published

2024-05-22

How to Cite

Sohail, R., Yazdaan, H. E. ., & Hoor, A. (2024). The Diagnostic Dilemma of Heyde Syndrome: A Case Report. THE STETHO, 5(2). Retrieved from https://thestetho.com/index.php/ts/article/view/70

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