Professional paper

https://doi.org/10.15836/ccar2020.262

Heyde Syndrome – An Often-Neglected Pathophysiological Course in Daily Clinical Practice

Daren Lučinger ; Special Hospital for Medical Rehabilitation Krapinske Toplice, Krapinske Toplice, Croatia
Nenad Lakušić ; Special Hospital for Medical Rehabilitation Krapinske Toplice, Krapinske Toplice, Croatia; Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, Osijek, Croatia; Faculty of Medicine Osijek, J. J. Strossmayer University of Osijek, Osijek, Croatia
Duško Cerovec ; Special Hospital for Medical Rehabilitation Krapinske Toplice, Krapinske Toplice, Croatia; Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, Osijek, Croatia; Faculty of Medicine Osijek, J. J. Strossmayer University of Osijek, Osijek, Croatia
Krunoslav Fučkar ; Special Hospital for Medical Rehabilitation Krapinske Toplice, Krapinske Toplice, Croatia; Faculty of Medicine Osijek, J. J. Strossmayer University of Osijek, Osijek, Croatia
Ljubica Vincelj Šalković ; Special Hospital for Medical Rehabilitation Krapinske Toplice, Krapinske Toplice, Croatia

Abstract

The classic triad of aortic stenosis symptoms – angina pectoris, heart failure, and syncope - is well-known among clinicians, but manifestations of aortic stenosis on other systems often remain unrecognized. Gastrointestinal (GI) angiodysplasia, like aortic stenosis, is degenerative disease and both entities are more common in older patients. Heyde syndrome refers to a triad of aortic stenosis, acquired coagulopathy (von Willebrand syndrome type 2A), and sideropenic anemia due to bleeding from gastrointestinal angiodysplasia or from an idiopathic site. Acquired coagulopathy arises from degradation of vWF multimers by the shear stress across the stenotic aortic valve. Aortic valve replacement leads to rise in vW factor multimers and ultimate resolution of gastrointestinal bleeding and sideropenic anemia. In patients with established aortic stenosis, development of iron deficiency anemia should raise the possibility of Heyde syndrome, but patients with GI bleeding with presence of angiodysplasia or failure of endoscopy to find the site of GI bleeding should also be evaluated for aortic stenosis.

Keywords

Heyde syndrome; aortic stenosis; anemia; bleeding; von Willebrand factor

Hrčak ID:

242968

URI

https://hrcak.srce.hr/242968

Publication date:

28.8.2020.

Article data in other languages: croatian

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