Abstract | December 16, 2022

Heyde Syndrome and COVID-Induced Hypercoagulability: A Case

Presenting Author: Samantha Barta, BA, Medical Student, 4th year, Edward Via College of Osteopathic Medicine, Blacksburg, VA

Coauthors: Randall Wasson, DO, Hospitalist, Internal Medicine, Turkey Creek Medical Center, Knoxville, TN; Damian Sooklal, MD, Hospitalist, Internal Medicine, Johnston Memorial Hospital, Abingdon, VA.

Learning Objectives

  1. Identify the patient population mostly likely to be affected by Heyde syndrome and describe the pathophysiology
  2. Discuss treatment options for patients with diagnosed Heyde syndrome and a history of deep vein thrombosis

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic continues to affect patients and health systems across the world, and present new challenges to team members taking care of those patients suffering from the disease and its sequelae. At the same time, Heyde syndrome, a condition linking gastrointestinal bleeding, aortic stenosis, and von Willebrand disease (vWD), remains likely underdiagnosed in the same patient population suffering the majority of hypercoagulability complications.

 

Case Presentation: 81 year old female with history of emphysema, heart failure, and aortic stenosis was diagnosed with COVID-19 pneumonia, subsequently developed bilateral tibial deep vein thromboses, and then presented with symptomatic anemia approximately one month later. Lab testing showed a hemoglobin of 5.5, and she underwent esophagogastroduodenoscopy, which revealed gastrointestinal angiodysplasia to be the source of her anemia. Her anticoagulation was stopped and she was treated with supplemental oxygen, proton pump inhibitors, iron supplementation, and blood transfusions.

 

Working diagnosis: Heyde Syndrome

 

Outcome: Her disease course became suspicious for Heyde syndrome, and illuminated important questions that could impact the care and prognosis of patients with similar conditions in the future as we continue to learn more about long term consequences and outcomes post-COVID-19, particularly in terms of their overlap with under-recognized conditions such as Heyde syndrome.

 

References:

  1. Theis SR, Turner SD. Heyde Syndrome. [Updated 2021 Jul 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551625/
  2. Pate GE, Chandavimol M, Naiman SC, Webb JG. Heyde’s syndrome: a review. J Heart Valve Dis. 2004;13(5):701-712.

 

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