Aortic stenosis and Heyde’s syndrome: A comprehensive review

Abstract

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.

Keywords: Heyde's syndrome; Aortic stenosis; Angiodysplasia; Transcatheter aortic valve replacement; Gastrointestinal bleed; Anti platelet

Core Tip: We summarize the literature on the aortic valve replacement in aortic stenosis and angiodysplasia (Heyde's syndrome). This is a very attractive area of interest for interventional gastroenterologists and cardiologists. Future studies may change the management aspect of Heyde's syndrome and pave a path for drawing specific guidelines and algorithms.