The daily educational pearl – Heyde’s syndrome

Your next patient presents to ED with GI bleeding. When you examine him, you think  that he has aortic stenosis. Two different disease processes… or maybe there is a link?

Heyde’s syndrome = association of aortic stenosis with GI bleeding from intestinal angiodysplasia


Patients with aortic stenosis have functional von Willebrand’s syndrome, as the von Willebrand’s multimers are mechanically disrupted when they pass through the narrow aortic valve.

The severity of bleeding correlates with the severity of the aortic stenosis (or of the transvalvular gradient). The bleeding episodes resolve when the aortic valve is replaced.

If you want to read more, there is a good review on Heyde’s syndrome here.