This is a 62-year-old woman with a history of double aortic valve lesion (severe aortic stenosis and moderate aortic insufficiency) with preserved systolic function.
Two years earlier he had been admitted to another hospital due to anemization and melena.
During admission, gastroscopy was performed without significant findings.
The study was continued with an endoscopic capsule that identified a bleeding point in yeyunal lesions which required an enteroscopy and marking of two jejunal vascular lesions.
CT was normal and tumor markers were negative.
One year later he was admitted to our hospital for the same reason and a normal octreotide scintigraphy was performed.
Arteriography showed a tortuosus arteriography of arterial vascularization dependent on the second jejunal branch of the superior mesenteric artery.
The new enteroscopy identified a new jejunal lesion distal to the previous ones that was coagulated with argon controlling bleeding.
The suspicion of Heyde's syndrome was established, and after deterioration of cardiac function, aortic valve replacement with a biological prosthesis was performed.
Although the patient no longer had melenas, mild alterations persisted in the blood count (discrete leucopenia, thrombopenia and anemia), so a monoclonal proteinogram IgGJ identifying a small gammaure was requested.
