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Heyde’s Syndrome Complicating Management in a Patient With High Bleeding and Thrombotic Risks

The association of severe aortic stenosis and gastrointestinal (GI) bleeding is a well-known phenomenon. The pathogenesis involves an acquired deficiency of von Willebrand factor (vWF) due to shear stress resulting in alteration of vWF morphology. This results in in-appropriate cleavage of vWF multi...

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Detalles Bibliográficos
Autores principales: Ahmed, Talha, Haque, Reyaz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7317131/
https://www.ncbi.nlm.nih.gov/pubmed/32601556
http://dx.doi.org/10.7759/cureus.8280
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author Ahmed, Talha
Haque, Reyaz
author_facet Ahmed, Talha
Haque, Reyaz
author_sort Ahmed, Talha
collection PubMed
description The association of severe aortic stenosis and gastrointestinal (GI) bleeding is a well-known phenomenon. The pathogenesis involves an acquired deficiency of von Willebrand factor (vWF) due to shear stress resulting in alteration of vWF morphology. This results in in-appropriate cleavage of vWF multimers into smaller dysfunctional fragments. Patients with atrial fibrillation and high thrombotic risk require anticoagulation for stroke prophylaxis. We describe a case of severe intermittent GI bleeding in a patient with atrial fibrillation while being on warfarin and other novel anticoagulants. This case highlights the role of severe aortic stenosis and resultant acquired vWF deficiency in complicating decision making in patients with a need for anticoagulation due to high thrombotic risk.
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spelling pubmed-73171312020-06-28 Heyde’s Syndrome Complicating Management in a Patient With High Bleeding and Thrombotic Risks Ahmed, Talha Haque, Reyaz Cureus Cardiac/Thoracic/Vascular Surgery The association of severe aortic stenosis and gastrointestinal (GI) bleeding is a well-known phenomenon. The pathogenesis involves an acquired deficiency of von Willebrand factor (vWF) due to shear stress resulting in alteration of vWF morphology. This results in in-appropriate cleavage of vWF multimers into smaller dysfunctional fragments. Patients with atrial fibrillation and high thrombotic risk require anticoagulation for stroke prophylaxis. We describe a case of severe intermittent GI bleeding in a patient with atrial fibrillation while being on warfarin and other novel anticoagulants. This case highlights the role of severe aortic stenosis and resultant acquired vWF deficiency in complicating decision making in patients with a need for anticoagulation due to high thrombotic risk. Cureus 2020-05-25 /pmc/articles/PMC7317131/ /pubmed/32601556 http://dx.doi.org/10.7759/cureus.8280 Text en Copyright © 2020, Ahmed et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiac/Thoracic/Vascular Surgery
Ahmed, Talha
Haque, Reyaz
Heyde’s Syndrome Complicating Management in a Patient With High Bleeding and Thrombotic Risks
title Heyde’s Syndrome Complicating Management in a Patient With High Bleeding and Thrombotic Risks
title_full Heyde’s Syndrome Complicating Management in a Patient With High Bleeding and Thrombotic Risks
title_fullStr Heyde’s Syndrome Complicating Management in a Patient With High Bleeding and Thrombotic Risks
title_full_unstemmed Heyde’s Syndrome Complicating Management in a Patient With High Bleeding and Thrombotic Risks
title_short Heyde’s Syndrome Complicating Management in a Patient With High Bleeding and Thrombotic Risks
title_sort heyde’s syndrome complicating management in a patient with high bleeding and thrombotic risks
topic Cardiac/Thoracic/Vascular Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7317131/
https://www.ncbi.nlm.nih.gov/pubmed/32601556
http://dx.doi.org/10.7759/cureus.8280
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