Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas 79430, USA.
Heart Lung. 2012 Jan-Feb;41(1):90-4. doi: 10.1016/j.hrtlng.2010.07.004. Epub 2011 Oct 11.
Obscure gastrointestinal (GI) bleeding can be a perplexing and difficult problem in elderly patients, especially if they are hemodynamically unstable. If aortic stenosis is also present, the cause of the GI bleeding may be explained. We present a 66-year-old man with a medical history of coronary artery disease who presented with acute GI bleeding. During his hospital course, the patient had a colonoscopy showing diffuse angiodysplasia and an echocardiogram showing severe aortic stenosis. This combination of angiodysplasia and aortic stenosis is known as Heyde's syndrome. It has been hypothesized that the aortic stenosis causes an acquired von Willebrand factor deficiency that leads to GI bleeding. Aortic valve replacement, when possible, can prevent recurrent GI bleeding in these cases, but medical decisions in these cases are complex and difficult.
老年人不明原因的胃肠道（GI）出血可能是一个令人费解和棘手的问题，特别是如果他们血流动力学不稳定。如果同时存在主动脉瓣狭窄，那么 GI 出血的原因可能就可以解释了。我们现在介绍一位 66 岁的男性患者，他有冠心病病史，因急性胃肠道出血就诊。在住院期间，患者进行了结肠镜检查，结果显示弥漫性血管扩张；超声心动图显示严重的主动脉瓣狭窄。这种血管扩张和主动脉瓣狭窄的组合被称为 Heyde 综合征。据推测，主动脉瓣狭窄导致获得性血管性血友病因子缺乏，从而导致 GI 出血。在这种情况下，尽可能进行主动脉瓣置换可以预防 GI 出血的复发，但这种情况下的医疗决策是复杂和困难的。
