Curriculum · Gastroenterology
Heyde syndrome
What it is
Heyde syndrome is the name given to angiodysplasia of the bowel seen together with aortic stenosis. In the differential diagnosis of lower GI bleeding, aortic stenosis is what points to angiodysplasia under this name.
Causes and risk
Aortic stenosis is the valve lesion tied to it. Angiodysplasia, together with colonic diverticula, is the usual source of acute painless lower GI bleeding in older adult patients, so older age and the valve lesion sit in the same picture. Anorectal causes such as hemorrhoids and anal fissure are the most common cause of rectal bleeding overall, particularly in young patients, and are a different picture.
How it presents
Bleeding is painless. It may be acute painless hematochezia, or chronic blood loss, in an older adult patient, which is the same pattern that also raises colonic tumor and polyp. Bloody diarrhea with tenesmus, abdominal pain and fever points to IBD instead, and LLQ abdominal pain with evidence of vascular disease points to ischemic colitis.