title: Acquired Von Willebrand Syndrome In Aortic Stenosis: Case Report And Review.
abstract: We present a case of a 61 year old man who presented with a 3 week history of easy bruising and ecchymoses in both thighs and right arm without significant trauma. Physical exam was remarkable for oozing gums, diminished second heart sound, a systolic ejection murmur at the aortic position with radiation to carotids, and delayed pulses. Laboratories were remarkable for iron deficiency anemia. Echocardiogram was consistent with severe aortic stenosis. Colonoscopy revealed several arteriovenous malformations throughout the colon. There is an association between severe aortic stenosis and gastrointestinal bleeding. The pathogenesis of Heyde's Syndrome involves iron deficiency anemia due to acquired von Willebrand factor (vWF) deficiency and ultimately gastrointestinal angiodysplasia. Correct diagnosis and management warrants a multidisciplinary approach.
authors.forename: Said
authors.initials: S
authors.lastname: Alsidawi
authors.forename: Marian
authors.initials: M
authors.lastname: Couto
authors.forename: Angel
authors.initials: A
authors.lastname: López-Candales
mesh_terms: D051722:ADAM Proteins / Q000378:metabolism*; D000071120:ADAMTS13 Protein; D016888:Angiodysplasia / Q000175:diagnosis / Q000209:etiology*; D001024:Aortic Valve Stenosis / Q000150:complications* / Q000503:physiopathology; D003113:Colonoscopy; D003928:Diabetic Nephropathies / Q000150:complications; D004438:Ecchymosis / Q000209:etiology; D004789:Enzyme Activation; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D055550:Protein Stability; D020836:Protein Structure, Quaternary; D033081:Shear Strength; D013577:Syndrome; D016312:Treatment Refusal; D014842:von Willebrand Diseases / Q000175:diagnosis / Q000209:etiology*; D014841:von Willebrand Factor / Q000737:chemistry
chemical_list: D014841:von Willebrand Factor; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human