Lourdusamy Dennisdhilak, Mupparaju Vamsee Krishna, Sharif Navila Fahmida, Ibebuogu Uzoma N
Internal Medicine, Methodist South Hospital, Memphis, TN 38116, United States.
Internal Medicine, University of Tennessee Health Science Center, Memphis, TN 38103, United States.
World J Clin Cases. 2021 Sep 6;9(25):7319-7329. doi: 10.12998/wjcc.v9.i25.7319.
Heyde's syndrome is an under reported systemic disease of gastrointestinal and cardiac manifestation in older adults. It is characterized by a triad of aortic stenosis, angiodysplasia with bleeding and acquired von Willebrand syndrome. It is characterized by proteolysis of high molecular weight multimers of von Willebrand Factor and loss of platelet mediated homeostasis. Heyde's syndrome is a treatable condition in most cases, especially in the current era of evolution in interventional cardiology and gastroenterology. There are currently no established guidelines in the management of this condition due to paucity of high quality studies, which warrant future trials. High index of suspicion and increasing the awareness of the syndrome among the general practitioners and sub-specialists will improve the diagnostic potential of Heyde's syndrome. Future studies may change the management aspect of Heyde's syndrome and pave a path for drawing specific guidelines and algorithms. The aim of our review article is to summarize the basic pathophysiology, diagnostics and management of Heyde's syndrome with a special attention to Transcatheter aortic valve replacement.
海德氏综合征是一种在老年人中未被充分报道的具有胃肠道和心脏表现的全身性疾病。它的特征是三联征，即主动脉瓣狭窄、血管发育异常伴出血以及获得性血管性血友病综合征。其特点是血管性血友病因子高分子量多聚体的蛋白水解以及血小板介导的内稳态丧失。在大多数情况下，海德氏综合征是一种可治疗的疾病，尤其是在当前介入心脏病学和胃肠病学不断发展的时代。由于高质量研究匮乏，目前尚无针对该病症管理的既定指南，这需要未来进行试验。高度怀疑指数以及提高全科医生和专科医生对该综合征的认识将提高海德氏综合征的诊断潜力。未来的研究可能会改变海德氏综合征的管理方式，并为制定具体指南和算法铺平道路。我们这篇综述文章的目的是总结海德氏综合征的基本病理生理学、诊断和管理，特别关注经导管主动脉瓣置换术。
