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- Title
Persistent Gastrointestinal Bleeding after Aortic Valve Replacement in Heyde's Syndrome.
- Authors
Ceasovschih, Alexandr; Alexa, Raluca-Elena; Șorodoc, Victorița; Balta, Anastasia; Constantin, Mihai; Coman, Adorata Elena; Petriș, Ovidiu Rusalim; Stătescu, Cristian; Sascău, Radu A.; Onofrei, Viviana; Diaconu, Alexandra-Diana; Morărașu, Bianca Codrina; Rusu-Zota, Gabriela; Șorodoc, Laurențiu
- Abstract
Heyde's syndrome (HS) represents an association between aortic stenosis and intestinal angiodysplasias, and it has been demonstrated that acquired von Willebrand disease plays a pivotal role in the pathophysiology of this syndrome. In patients with HS, von Willebrand factor deficiency represents an additional risk factor, further contributing to the risk of bleeding and anemia. We present the case of an 86-year-old patient diagnosed with HS and von Willebrand deficiency in 2018. Four years prior, the patient underwent surgical aortic valve replacement. Since then, she has been receiving chronic oral anticoagulation therapy with a vitamin K antagonist. The patient was admitted to the Internal Medicine Clinic due to semi-solid dark stools, diffuse abdominal pain, and asthenia. Upon examination, the patient presented with an altered general status and clinical signs suggestive of anemia. Laboratory findings revealed anemia with elevated INR and aPTT values. Colonic angiodysplasias were identified during a colonoscopy, although no sources of active bleeding were detected. On the 9th day of hospitalization, the patient experienced an episode of lower gastrointestinal bleeding. The pharmacological management was adjusted, and argon plasma coagulation was recommended. Following treatment of the angiodysplastic lesions, the patient's clinical evolution was favorable, with the correction of the anemia.
- Subjects
ELECTROCOAGULATION (Medicine); AORTIC valve transplantation; SYMPTOMS; VON Willebrand factor; AORTIC stenosis
- Publication
Journal of Clinical Medicine, 2024, Vol 13, Issue 15, p4515
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm13154515