An unrecognized disease in routine clinical practice: the Heyde’s syndrome

Heyde’s syndrome (HS) is a triade constituted by aortic stenosis, gastrointestinal angiodysplasia and deficiency of high-molecular-weight von Willebrand factor multimers. Until now few cases of HS has been reported and we believe of interest to add a new patient having this disorder. We report a case of HS in an 86-year-old female patient admitted for the second episode of melena in the last 4 months. A colonoscopy revealed a bleeding due to angiodysplasia in the ascending colon and an endoscopic argon laser photocoagulation of the colonic angiodysplasia was successfully carried out. Physicians should be aware of the possibilities of acquired von Willebrand disease and gastrointestinal bleeding from angiodysplasia in patients with aortic valve stenosis because a right diagnosis affects the management of these patients, especially in emergency situations.