Estimation of platelet function under high shear conditions to assist a rapid diagnosis of Heyde Syndrome.
Loss of high molecular weight von Willebrand factor (VWF) multimers in patients suffering from aortic valve stenosis and gastrointestinal (GI) bleeding has been regarded as the missing link between aortic stenosis and bleeding. Electrophoretic analysis of VWF multimers is laborious and time-consuming. Further, determination of overall haemostatic competence rather than evaluation of restricted portions thereof may be advantageous. Accumulating evidence suggests that, recently developed in vitro and ex vivo platelet reactivity tests under high shear conditions mirror the in vivo situation. We report on a case of a 79-year-old man who presented with recurrent GI bleeding and severe aortic stenosis. Platelet function testing under high shear conditions using the commercially available cone and plate(let) analyser-Impact-R revealed significantly impaired shear dependent platelet function, suggesting VWD. This test offers an easy to use diagnostic tool to evaluate platelet function in suspected Heyde Syndrome thus leading to immediate tailored patient's management.
Schmid
Werner
W
Center for Physiology and Pathophysiology, Institute of Physiology, Department of Internal Medicine III, Medical University of Vienna, Vienna 1090, Austria. werner.schmid@meduniwien.ac.at
Steindl-Munda
Petra
P
Petra
Steindl-Munda
SM
Madl
Christian
C
Christian
Madl
M
Budde
Ulrich
U
Ulrich
Budde
B
Volf
Ivo
I
Ivo
Volf
V
Panzer
Simon
S
Simon
Panzer
P
D000368:Aged; D001024:Aortic Valve Stenosis / Q000209:etiology; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D010477:Perfusion; D010974:Platelet Aggregation; D010979:Platelet Function Tests / Q000379:methods*; D014842:von Willebrand Diseases / Q000175:diagnosis*; D014841:von Willebrand Factor
D014841:von Willebrand Factor