Heyde Syndrome: A Literature Review

Background and Aims: Heyde syndrome, a triad of anemia from gastrointestinal (GI) bleeding, aortic valve stenosis, and acquired von Willebrand syndrome, primarily affects individuals over 65. Management requires a multidisciplinary approach, including medical therapy, endoscopic intervention, and valve replacement. Despite advances, many aspects remain unclear. This review explores the epidemiology, pathophysiology, and management of Heyde syndrome while highlighting areas for future research. Methods: A comprehensive search of PubMed and Google Scholar focused on English-language human studies, including case reports, clinical trials, reviews, and expert guidelines. Additional literature on Von Willebrand syndrome and GI angiodysplasia was reviewed. The final search was completed on April 5, 2025. Results: Aortic valve replacement improves outcomes and hematologic abnormalities. Transcatheter aortic valve replacement (TAVR) showed lower rates of life-threatening bleeding, fewer perioperative complications, and reduced transfusions compared to surgical replacement. Guidelines recommend dual antiplatelet therapy (DAPT) for 3-6 months post-TAVR, with 79%-86% of patients experiencing no recurrence of GI bleeds. Management of intestinal angiodysplasia often shows high recurrence rates due to persistent lesions and vWS-2A. Surgical valve replacement also improves bleeding control, even with anticoagulation. Aortic valve replacement should be first-line therapy in severe aortic stenosis with chronic GI bleeding. Conclusion: Heyde syndrome remains a complex and often underrecognized condition in elderly populations. Continued research is critical to deepen understanding and improve patient outcomes, allowing for more personalized and effective care strategies.