Gastrointestinal bleeding associated to aortic valve stenosis (Heyde's syndrome): a case series and literature review

Background The association among aortic valve stenosis, gastrointestinal bleeding, and anaemia due to arteriovenous malformations, known as Heyde's syndrome (HS), is poorly understood and controversial. Recently, acquired Type 2A von Willebrand syndrome (vWS 2A) was shown to be the most likely aetiological mechanism of anaemia. Case summary We report two cases of HS in whom the percutaneous replacement of the aortic valve was resolutive for iron deficiency anaemia. Discussion Iron deficiency anaemia and aortic stenosis are a common association in the elderly, so much that frequently; in such cases, the correction of the valvulopathy is often excluded as pre-operative anaemia is associated with higher morbidity and mortality. From this perspective, the correct diagnosis of HS is crucial to guide the decision to correct valvulopathy, as valvular substitution is resolutive for both anaemic disorders and aortic stenosis

Automated summary

This article reports two cases of Heyde's syndrome treated successfully for anemia by percutaneous aortic valve replacement. Iron deficiency anemia and aortic stenosis are commonly associated in the elderly, and the correct diagnosis of Heyde's syndrome is crucial for deciding whether to treat valve stenosis.