Background: Heyde syndrome is known as a triad of calcific aortic stenosis, anemia due to gastrointestinal bleeding from angiodysplasia, and acquired type 2A von Willebrand disease. This acquired hemorrhagic disorder is characterized by the loss of the large von Willebrand factor multimers due to the shear stress across the diseased aortic valve. The most frequently observed type of bleeding in these patients is mucosal or skin bleeding, such as epistaxis, followed by gastrointestinal bleeding. On the other hand, intracranial hemorrhage complicating Heyde syndrome is extremely rare.
Case Presentation: A 77-year-old woman presented to our hospital with severe aortic stenosis and severe anemia due to gastrointestinal bleeding and was diagnosed with Heyde syndrome. Although aortic valve replacement was performed without recurrent gastrointestinal bleeding, postoperative life-threatening acute subdural hematoma occurred with a marked midline shift. Despite prompt surgical evacuation of the hematoma, she did not recover consciousness and she died 1 month after the operation.
Conclusions: Postoperative subdural hematoma is rare, but it should be kept in mind as a devastating hemorrhagic complication, especially in patients with Heyde syndrome.
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| http://dx.doi.org/10.1186/s13019-017-0629-x | DOI Listing |
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Article Synopsis
- Heyde syndrome consists of anemia, aortic valve stenosis, and acquired von Willebrand syndrome, yet it remains under-recognized in clinical settings.
- A 70-year-old woman with severe iron-deficiency anemia and aortic stenosis was diagnosed with Heyde syndrome after extensive testing that ruled out other bleeding sources.
- Aortic valve replacement surgery improved her anemia and symptoms, highlighting the need for awareness of Heyde syndrome in cases of unexplained anemia, particularly when associated with aortic stenosis.
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