Arq. Bras. Cardiol. 2021; 117(3): 518-519
Should Patients with Heyde’s Syndrome Undergo Early Valve Intervention?
Marcelo Dantas Tavares de Melo
, Jose Luiz Barros Pena
, Jorge de Oliveira Júnior, Vera Maria Cury Salemi
This Short Editorial is referred by the Research article "Heyde’s Syndrome: Therapeutic Strategies and Long-Term Follow-Up".
The epidemiological profile of patients with aortic stenosis has changed with the aging of the population, characterized by an increase in associated comorbidities. Thanks to the revolution in percutaneous aortic valve treatment, many patients who previously would have limited survival and quality of life have benefited from the possibility of curative treatment. On the other hand, the clinical challenges that arise in this population reinforce not only the consolidated relevance of the heart team but also of other specialties such as oncology and hematology.
The interesting study published in the current issue reinforces the importance of the association between Heyde’s syndrome and aortic stenosis, with increased bleeding in this population. However, it is important to highlight in this context the frequently associated comorbidities that may contribute to eventual digestive bleeding, such as the association between aortic stenosis and neoplasm, since both share the same risk factors, particularly colon cancer neoplasm. This one presents with cardinal clinical signs: anemia and low gastrointestinal bleeding. In this context, the exclusion of neoplasm is mandatory, even in the suspicion of Heyde’s Syndrome. We can also describe other frequently associated comorbidities that add bleeding risk due to the therapy used, such as coronary artery disease, which usually uses antiplatelet therapy, or dual anti-aggregation after percutaneous coronary intervention with a drug-eluting stent.
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