title: Severe aortic valve stenosis and nosebleed.
abstract: Aortic valve stenosis is known to be associated with loss of high molecular von Willebrand multimers. This can lead to gastrointestinal bleeding in patients with gastrointestinal angiodysplasia, the Heyde syndrome. Here we present a case of anaemia and severe epistaxis associated with acquired von Willebrand syndrome. Gastrointestinal endoscopy revealed no bleeding source. Calcifying aortic stenosis was confirmed by echocardiography. Loss of high molecular weight multimers of von Willebrand factor in our patient was shown by immunoblot analysis. If severe epistaxis occurs in the context of symptomatic aortic valve stenosis, it might be an additional reason to recommend valve replacement surgery to the patient.
authors.forename: Johannes
authors.initials: J
authors.lastname: Schödel
authors.forename: Achim
authors.initials: A
authors.lastname: Obergfell
authors.forename: Alexander H
authors.initials: AH
authors.lastname: Maass
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D015150:Echocardiography, Doppler; D004844:Epistaxis / Q000097:blood / Q000209:etiology*; D006801:Humans; D015151:Immunoblotting; D008297:Male; D012720:Severity of Illness Index; D014842:von Willebrand Diseases / Q000097:blood / Q000150:complications*; D014841:von Willebrand Factor / Q000378:metabolism
chemical_list: D014841:von Willebrand Factor