4th Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo City, Shimane, Japan.
Med Sci Monit. 2010 Sep;16(9):CS107-9.
Aortic valve sclerosis, calcification, and stenosis are common in the elderly. Increased life expectancy has resulted in a growing population of elderly people, with a corresponding increase in the number of patients with these degenerative aortic valve diseases.
We report a case of severe aortic stenosis in an 82-year-old woman with bleeding due to colonic angiodysplasia. The patient presented with anemia unexpectedly before her aortic valve replacement. Colon fiberscopy revealed that colonic angiodysplasia was responsible for the bleeding. The lesion was treated with endoscopic clipping before the successful aortic valve replacement. Additionally, her immunoblot analysis detected a decrease of large molecular weight multimers of von Willebrand factor.
The relationship between aortic valve stenosis, acquired von Willebrand disease and gastrointestinal bleeding in elderly patients is known as Heyde syndrome. Clinicians should be aware of the possibilities of acquired von Willebrand disease and gastrointestinal bleeding from angiodysplasia in patients with aortic valve stenosis.
主动脉瓣硬化、钙化和狭窄在老年人中很常见。预期寿命的延长导致老年人口不断增加，相应地，患有这些退行性主动脉瓣疾病的患者人数也在增加。
我们报告了一例 82 岁老年女性因结肠血管发育不良导致出血的严重主动脉瓣狭窄病例。该患者在主动脉瓣置换前意外出现贫血。结肠镜检查显示结肠血管发育不良是出血的原因。在成功进行主动脉瓣置换之前，对病变进行了内镜夹闭治疗。此外，她的免疫印迹分析检测到大分子量 von Willebrand 因子多聚体减少。
主动脉瓣狭窄、获得性 von Willebrand 病和老年患者胃肠道出血之间的关系被称为 Heyde 综合征。临床医生应意识到主动脉瓣狭窄患者存在获得性 von Willebrand 病和血管发育不良导致胃肠道出血的可能性。
