A prospective controlled evaluation of endoscopic detection of angiodysplasia and its association with aortic valve disease☆,☆☆,★
Section snippets
MATERIALS AND METHODS
Forty patients who underwent gastrointestinal endoscopy between July 1992 and November 1993 for clinical indications and were found to have angiodysplasia constituted the study group. Indications for performing esophagogastroduodenoscopy (EGD) or colonoscopy are shown in Table 1. All the endoscopic procedures were performed by GI Fellows of Wright State University under direct supervision of two attending gastroenterologists (NG, CB). The criterion for the diagnosis of angiodysplasia was the
RESULTS
All patients in the study were men ranging in age from 50 to 91 years. Twenty-one patients had angiodysplasias of the UGI tract and 20 patients had colonic angiodysplasias (1 patient had both). These lesions were discovered during the performance of 1103 upper endoscopy examinations and 554 colonoscopic examinations during the study period of July 1992 to November 1993. Nine patients in the study group and four patients in the control group had both upper endoscopy and colonoscopy. The
DISCUSSION
In 1958 Heyde1 reported 10 patients with gastrointestinal bleeding of unknown origin who had clinical signs of aortic stenosis. About a month later, Schwartz3 suggested a similar association. Thus the foundation of this controversial association was laid, which has continued to spark case reports and studies to date. Cattell was quoted in a clinicopathological conference on such a case in 1965.4 He suggested that these patients bled from a vascular lesion in the ascending colon that the
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Cited by (79)
Alarming Increasing Trends in Hospitalizations and Mortality With Heyde's Syndrome: A Nationwide Inpatient Perspective (2007 to 2014)
2019, American Journal of CardiologyLower Gastrointestinal Bleeding
2019, Clinical Gastrointestinal EndoscopyOccult and Unexplained Chronic Gastrointestinal Bleeding
2019, Clinical Gastrointestinal EndoscopyReview on gastrointestinal angiodysplasia throughout the gastrointestinal tract
2017, Best Practice and Research: Clinical GastroenterologyCitation Excerpt :This relationship has not been observed with any other form of valvular heart disease or with ischaemic heart disease. Current opinion is that the passage of blood through a defective aortic valve causes the destruction of high molecular weight multimers of von Willebrand factor, leading to an acquired form of von Willebrand disease and a consequent bleeding tendency [12–15]. There is a more convincing association between GIAD and chronic renal failure (CRF), with AD responsible for an up to a third of GI bleeding events in this population [16,17].
Gastrointestinal Bleeding, Aortic Stenosis, and the Hiding Culprit
2015, American Journal of MedicineCitation Excerpt :Among the methods for detection, the most reliable test is gel electrophoresis.4 The reported prevalence of aortic stenosis in patients with gastrointestinal angiodysplasia ranges from 0 to 41%, and this variable association has led some to question the existence of Heyde's syndrome.5 The strongest evidence in support of the association between aortic stenosis and gastrointestinal hemorrhage is the consistent alleviation of bleeding after aortic valve replacement.6
Colonic Bleeding and Ischemia
2012, Shackelford's Surgery of the Alimentary Tract: Volume 1-2, Seventh Edition
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From the Department of Medicine, Wright State University School of Medicine, Dayton, Ohio; and the Department of Medicine, Department of Veterans Affairs Medical Center, Dayton, Ohio.
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Reprint requests: Manoop S. Bhutani, MD, Medical Service (111), VAMC, 4100 W. Third St., Dayton, OH 45428.
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