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Anales del Sistema Sanitario de Navarra

Print version ISSN 1137-6627

Abstract

SANTOS, V.M.; SANTOS, L.A.M.; MODESTO, A.A.D.  and  AMUI, M.O.. Heyde syndrome in a 71-year-old man who underwent chest radiotherapy at young age. Anales Sis San Navarra [online]. 2013, vol.36, n.2, pp.339-345. ISSN 1137-6627.  http://dx.doi.org/10.4321/S1137-66272013000200020.

We report the case of a 71-year-old man with diagnosis of aortic valve stenosis for ten years, who came to hospital because of breathlessness during the previous two months and recent low intestinal hemorrhage. On admission, laboratory tests and upper gastrointestinal endoscopy and colonoscopy revealed anemia and bleeding cecal angiodysplasia. The echocardiography study showed a severe aortic stenosis. Classical Heyde syndrome is described as the association of aortic stenosis, bleeding gastrointestinal angiodysplasia and secondary anemia. The antecedent of mediastinal radiotherapy for treatment of Hodgkin´s disease during his youth, and eventual late cardiac adverse effects that may include aortic or mitral valve disturbances are highlighted. Electrocoagulation with argonium was performed on the sites of active bleeding during the colonoscopy. In sequence, surgical replacement by bioprothesis was done on the aortic valve. The patient remains asymptomatic, under long-term outpatient surveillance, with normal control evaluations. The aim of this case study is to emphasize difficulties related to diagnosis, and to highlight the role of endoscopy and imaging studies to confirm a hypothesis of this underestimated condition.

Keywords : Angiodysplasia; Aortic valve stenosis; Colon bleeding; Heyde syndrome; Mediastinal radiotherapy.

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