Heyde syndrome

As Heyde's syndrome is a syndrome ( syndrome hereinafter) selected from the combination of an acquired aortic valve stenosis and bleeding from malformed blood vessels ( angiodysplasia of the ascending part of) the colon is composed. Sometimes the anemia caused by the bleeding is also considered part of the syndrome. It was named after the American internist Edward C. Heyde, who described the syndrome in 1958.

Epidemiology

The exact prevalence of the syndrome is unknown. In a 2003 study of 73 angiodysplasia patients, echocardiography found aortic valve stenosis in 31 percent of the patients . In the control group, the stenosis was only found in 14 percent of those examined.

Symptoms

Bleeding in the gastrointestinal tract manifests itself in bloody vomiting , black stools or blood deposits on the stool. Severe aortic valve stenosis manifests itself in shortness of breath ( dyspnea ), chest tightness ( angina pectoris ) and paroxysmal unconsciousness ( syncope ). However, lighter forms can also exist without symptoms.

causes

The causal connection between the stenosis due to calcification and degeneration of the aortic valve as well as bleeding from malformed blood vessels in the area of ​​the ascending colon and the caecum has not yet been clarified. A disorder in the regulation of blood coagulation with a reduction in the Von Willebrand factor is suspected , for which there is no evidence so far.

Diagnosis

During a colonoscopy because bleeding has occurred, the blood vessel malformations ( angiodysplasias ) can be detected. A stenosis of the aortic valve can echocardiography confirmed. The usual diagnostic procedures for Willebrand-Jürgens syndrome can be normal due to only minor changes.

therapy

Symptom-related treatment includes blood transfusion , desmopressin, and factor VIII preparations. In case reports it has been described that the replacement of the affected heart valve leads to the healing of the intestinal bleeding. Partial removal of the large intestine ( colectomy ) has also been used successfully as a treatment for intestinal bleeding.

Web links

• Heyde Syndrome at Ganfyd.org

Individual evidence

1. ↑ MW Massyn, SA Khan: Heyde syndrome: a common diagnosis in older patients with severe aortic stenosis. In: Age Aging. March 10, 2009 (Epub), PMID 19276092
2. ^ EC Heyde: Gastrointestinal bleeding in aortic stenosis. In: N Eng J Med . 259 (1958), p. 196.
3. ↑ P. Batur, WJ Stewart, JH Isaacson: Increased prevalence of aortic stenosis in patients with arteriovenous malformations of the gastrointestinal tract in Heyde syndrome. In: Arch Intern Med . 163 (2003), pp. 1821-1824, PMID 12912718 , doi: 10.1001 / archinte.163.15.1821
4. ↑ W. Knobloch et al.: Calcifying aortic valve stenosis and occult gastrointestinal bleeding (Heyde syndrome): Description of two case reports. In: Zeitschr Kardiol. 88 (1999), pp. 448-453. doi: 10.1007 / s003920050308
5. ^ NH Larsen: Heyde syndrome. In: Ugeskr Laeger. 159 (1997), pp. 4628-4630, PMID 9245037
6. ↑ TE Warkentin, JC Moore, DG Morgan: Aortic stenosis and bleeding gastrointestinal angiodysplasia: Is acquired von Willebrand's disease the link? In: Lancet. 340 (1992), pp. 35-37, doi : 10.1016 / 0140-6736 (92) 92434-H , PMID 1351610 .
7. ↑ A. Vincentelli, S. Susen, T. Le Tourneau and others: Acquired von Willebrand syndrome in aortic stenosis. In: N Engl J Med. 349 (2003), pp. 343-349. doi: 10.1056 / NEJMoa022831 , PMID 12878741
8. ↑ S. Henne, U. Denzer, U. Seitz, J. Göttsche, N. Soehndra, A. Lohse: Recurrent gastrointestinal bleeding in aortic valve stenosis (Heyde syndrome): an indication for aortic valve replacement? Case report and literature review. In: Zeitschr Gastroenterol. 45 (2997), pp. 245-249. PMID 17357954
9. ↑ M. Ogano, YK Iwasaki, H. Takano, M. Takayama, T. Takano, Y. Fukuda: Successful colectomy for the treatment of repetitive bleeding from colonic angiodysplasia in a patient with Heyde syndrome.  ( Page no longer available , search in web archives )  Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice. In: Intern Med. 45 (2006), pp. 355-358. PMID 16617184 , doi: 10.2169 / internalmedicine.45.1526  

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