Heyde syndrome describes the triad of
aortic stenosis, acquired coagulopathy, and
anemia due to
bleeding from intestinal
angiodysplasia. An 87-year-old man with
iron deficiency anemia due to
melena was admitted to our hospital. On examination, a
systolic murmur was heard and echocardiography confirmed the presence of
aortic stenosis. Esophagogastroduodenoscopy and colonoscopy were unremarkable.
Capsule endoscopy and double balloon endoscopy revealed
angiodysplasia throughout the small intestine. Laboratory investigations were significant for reduced plasma levels of high molecular weight
von Willebrand factor multimers. On the basis of these findings, the patient was diagnosed with Heyde syndrome. The patient required frequent
blood transfusions because of the intestinal
bleeding, and underwent bioprosthetic aortic valve replacement. Twenty months after the operation, the gastrointestinal
bleeding resolved and the patient no longer required
blood transfusions. This is the first case report to describe an improvement in
bleeding from
angiodysplasia, one year after aortic valve replacement. It demonstrates the effective treatment of Heyde syndrome with aortic valve replacement, and highlights the importance of considering this differential diagnosis when evaluating patients presenting with repeated episodes of gastrointestinal
bleeding and a concurrent
systolic murmur.