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CASE REPORT
Year : 2016  |  Volume : 2  |  Issue : 2  |  Page : 243-248

Heyde/Heyde-Warkentin syndrome: A case report and literature review


1 Department of Internal Medicine, St. Luke's University Hospital Network, Bethlehem, Pennsylvania 18015, USA
2 Department of Family Medicine, St. Luke's University Hospital Network, Bethlehem, Pennsylvania 18015, USA
3 Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania 19140, USA

Correspondence Address:
Sudip Nanda
Department of Internal Medicine, St. Luke's University Hospital Network, 801 Ostrum Street, Bethlehem, Pennsylvania 18015
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2455-5568.196868

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We present a case of a 77-year-old man admitted for chronic anemia secondary to recurrent gastrointestinal (GI) bleeding due to angiodysplasia with aortic stenosis (AS). Our patient was diagnosed with Heyde's syndrome. We review Heyde's syndrome, a combination of an acquired deficiency of the largest multimers of von Willebrand's factor (vWF) (Type 2A deficiency), bleeding angiodysplasia, and AS. AS causes high shearing forces on vWF, provoking changes in its shape that promote its cleavage, which further impairs the clotting ability of platelets. These patients are prone to clinically significant GI bleeds. Medical therapy offers little long-term benefit. Aortic valve replacement (AVR) frequently provides resolution of recurrent bleeds in up to 93% of patients. Recurrent bleeding in Heyde's syndrome is not an indication for AVR in the absence of symptomatic AS. AVR should be seriously considered in all cases of Heyde's syndrome. The following core competencies are addressed in this article: Patient care and medical knowledge.


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