You Can’t Heyde Forever

Pedro Pires; Inês Costa; Alexandra Raposo

doi:10.12890/2018_000896

You Can’t Heyde Forever

Pedro Pires Internal Medicine Service 1.2, Hospital de São José, Centro Hospitalar Lisboa Central, E.P.E – Lisboa, Portugal
Inês Costa Internal Medicine Service 1.2, Hospital de São José, Centro Hospitalar Lisboa Central, E.P.E – Lisboa, Portugal
Alexandra Raposo Internal Medicine Service 1.2, Hospital de São José, Centro Hospitalar Lisboa Central, E.P.E – Lisboa, Portugal

DOI: https://doi.org/10.12890/2018_000896

Keywords

Aortic stenosis, intestinal angiodysplasia, Heyde’s syndrome, acquired von Willebrand disease

Abstract

Heyde’s syndrome describes an association between aortic stenosis and a predisposition to bleeding from intestinal angiodysplasia resulting from acquired von Willebrand disease.
We present the case of an 82-year-old woman with recurrent intestinal bleeding, severe anaemia and secondary myocardial infarction. Investigation identified ileal angiectasia as the source of haemorrhage. As echocardiography revealed severe aortic stenosis the patient underwent surgical valve replacement. At her 3-month follow-up, the patient reported no new bleeding episodes and her functional status had improved.
This case highlights Heyde’s syndrome, an entity probably underdiagnosed despite the high prevalence of aortic stenosis and intestinal angiodysplasia in elderly patients.

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