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Angiodysplasia Heyde Syndrome — RACP Adult Medicine MCQ

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HardGastroenterologyAngiodysplasia Heyde SyndromeRACP Adult Medicine

A 75-year-old woman on aspirin presents with painless bright red rectal bleeding. Colonoscopy shows multiple arteriovenous malformations in the caecum and ascending colon with active oozing from one lesion. She has aortic stenosis. Hb is 88 g/L with chronic iron deficiency. What is the most likely diagnosis?

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Correct answer: B — Angiodysplasia

Colonic angiodysplasia (arteriovenous malformations) in the caecum/ascending colon with chronic iron deficiency anaemia and aortic stenosis is Heyde syndrome (association between AS and GI bleeding from angiodysplasia via acquired von Willebrand syndrome type 2A — loss of high-molecular-weight VWF multimers from shear stress). Treatment: endoscopic argon plasma coagulation for bleeding lesions, AVR may resolve the bleeding by correcting the VWF deficiency.

Reference: eTG GI – 2024 – Angiodysplasia; Heyde Syndrome Review