LABS: Hb - Baseline: 8,5 Ht: 21.7% Plat: 159 x 10³ WBC: 3.74 x 10³ Cr: 2.1 - baseline 2.1 BUN: 20 LDH, Vitamin B12, and Folic Acid: Normal Iron Studies: Serum Iron 25 Ferritin: 20 TIBC: 400 Transferrin Sat: 6% Ret. Count: 1% Coagulation profile normal Fecal occult blood positive
IMAGING: EKG: LVH, low voltage, enlarged left atrium Echo: 62% Left ventricle: eccentric hypertrophy with segmental wall motion abnormalities Aortic valve thickening with severe stenosis and moderate insufficiency.
COLONOSCOPY: Angiodysplasia in the cecum and ascending colon Colonic diverticula
Aortic Stenosis SAD: Syncope Angina Dyspnea
Diagnosis: Heyde Syndrome Aortic stenosis → Shear stress → Loss of HMW vWF multimers → Acquired von Willebrand disease.
Tx: TAVI preferred for symptomatic patients > 80 yo or younger patients or any age with high prohibited surgical risk or with age expectancy <10 y vs SAVI
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