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Aortic Stenosis and Unexplained Gastrointestinal Bleeding

Aortic Stenosis and Unexplained Gastrointestinal Bleeding Abstract Recently, we have encountered a group of patients with aortic stenosis who present with recurrent, often massive, unexplained gastrointestinal hemorrhage. Our attention was directed to this association when 4 such patients were admitted to the Massachusetts General Hospital during a single 2-week interval. A study of this clinical association was undertaken by analysis of a large group of consecutive patients with gastrointestinal bleeding. Patients with obvious sources for bleeding were analyzed for associated aortic valvular disease and, in addition, patients with aortic stenosis proven at autopsy or occasionally left heart catheterization were studied with respect to history of gastro-intestinal hemorrhage. Heyde1 and Schwartz2 in 1958 have called attention previously to the association of gastrointestinal bleeding and aortic stenosis, but no other references to this were found in a review of the literature. Plan of Study The records of 1,782 consecutive patients, diagnosed as having gastrointestinal bleeding and admitted References 1. Heyde, E. C.: Correspondence , New Engl. J. Med. 259:196, 1958. 2. Schwartz, B. M.: Correspondence , New Engl. J. Med. 259:456, 1958. 3. McGinn, S., and White, P. D.: Clinical Observations on Aortic Stenosis , Amer. J. Med. Sci. 188:1-5, 1934.Crossref 4. Kumpe, C. W., and Bean, W. B.: Aortic Stenosis: A Study of the Clinical and Pathological Aspects of 107 Proven Cases , Medicine 27:139-185, 1948.Crossref 5. Mitchell, A. M.; Sackett, C.; Hunzicker, W. J., and Levine, S.: Clinical Features of Aortic Stenosis , Amer. Heart J. 48:684-720, 1954.Crossref 6. Bergeron, J.; Abelmann, W. H.; Vazquez-Milan, H., and Ellis, L. B.: Aortic Stenosis: Clinical Manifestations and Course of the Disease , A.M.A. Arch. Intern. Med. 94:911-924, 1954.Crossref 7. Grönblad, E.: Angioid Streaks: Pseudoxanthoma Elasticum; vorläufige Mitteilung , Acta Ophthal. 7:329, 1929.Crossref 8. Strandberg, J.: Pseudoxanthoma Elasticum , Zbl. Haut. Geschlechtskr. 31:689, 1929. 9. Robertson, M. G., and Schroder, J. S.: Pseudoxanthoma Elasticum , Amer. J. Med. 27:433-442, 1959.Crossref 10. Kaplan, L., and Hartman, S. W.: Elastica Disease: Case of Grönblad-Strandberg Syndrome with Gastrointestinal Hemorrhage , A.M.A. Arch. Intern. Med. 94:489-492, 1954.Crossref 11. Woo, J. C., Jr., and Chandler, F. W.: Pseudoxanthoma Elasticum with Gastric Hemorrhage: Re-Report of a Case , Ann. Intern. Med. 49:215-222, 1958.Crossref 12. Carlborg, U.; Ejrup, B.; Grönblad, E., and Lund, F.: Vascular Studies in Pseudoxanthoma Elasticum and Angioid Streaks , Acta Med. Scand. Suppl. 350, 1959. 13. Weber, J. M.; Nash, E. C., and Gregg, L. A.: Hemorrhage from the Upper Gastrointestinal Tract: Report of 300 Cases and Discussion of Treatment , J.A.M.A. 165:1899-1905, 1957.Crossref 14. Schiff, L.: Hematemesis and Melena , Clinics 2:1542-1567, 1944. 15. Crohn, B. B.; Marshak, R. H., and Galinsky, D.: Repeated Gastroduodenal Hemorrhages Without Discoverable Explanation , Gastroenterology 10:120-128, 1948. 16. Gott, J. R., Jr.; Smith, E. L., and Dornan, D. D.: Acute Severe Upper Gastrointestinal Hemorrhage: A Review of 195 Cases , Ann. Intern. Med. 36:1001-1016, 1952.Crossref 17. Welch, C. E.: Treatment of Acute, Massive Gastroduodenal Hemorrhage , J.A.M.A. 141:1113-1110, 1949.Crossref 18. Costello, C.: Massive Hematemesis: Analysis of 300 Consecutive Cases , Ann. Surg. 129:289-298, 1949.Crossref 19. Dooley, B. N.; Gorden, W. B., and Tuttle, L. L. D.: Massive Gastrointestinal Hemorrhage of Undetermined Origin , Amer. J. Surg. 94:718-722, 1957.Crossref 20. Hoffman, F. G.; Zimmerman, S. L., and Cardwell, E. S., Jr.: Massive Intestinal Infarction Without Vascular Occlusion Associated with Aortic Insufficiency , New Engl. J. Med. 263:436, 1960.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Aortic Stenosis and Unexplained Gastrointestinal Bleeding

WILLIAMS, RALPH C.
Archives of Internal Medicine , Volume 108 (6) – Dec 1, 1961
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References (23)

Publisher
American Medical Association
Copyright
Copyright © 1961 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1961.03620120043007
Publisher site
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Abstract

Abstract Recently, we have encountered a group of patients with aortic stenosis who present with recurrent, often massive, unexplained gastrointestinal hemorrhage. Our attention was directed to this association when 4 such patients were admitted to the Massachusetts General Hospital during a single 2-week interval. A study of this clinical association was undertaken by analysis of a large group of consecutive patients with gastrointestinal bleeding. Patients with obvious sources for bleeding were analyzed for associated aortic valvular disease and, in addition, patients with aortic stenosis proven at autopsy or occasionally left heart catheterization were studied with respect to history of gastro-intestinal hemorrhage. Heyde1 and Schwartz2 in 1958 have called attention previously to the association of gastrointestinal bleeding and aortic stenosis, but no other references to this were found in a review of the literature. Plan of Study The records of 1,782 consecutive patients, diagnosed as having gastrointestinal bleeding and admitted References 1. Heyde, E. C.: Correspondence , New Engl. J. Med. 259:196, 1958. 2. Schwartz, B. M.: Correspondence , New Engl. J. Med. 259:456, 1958. 3. McGinn, S., and White, P. D.: Clinical Observations on Aortic Stenosis , Amer. J. Med. Sci. 188:1-5, 1934.Crossref 4. Kumpe, C. W., and Bean, W. B.: Aortic Stenosis: A Study of the Clinical and Pathological Aspects of 107 Proven Cases , Medicine 27:139-185, 1948.Crossref 5. Mitchell, A. M.; Sackett, C.; Hunzicker, W. J., and Levine, S.: Clinical Features of Aortic Stenosis , Amer. Heart J. 48:684-720, 1954.Crossref 6. Bergeron, J.; Abelmann, W. H.; Vazquez-Milan, H., and Ellis, L. B.: Aortic Stenosis: Clinical Manifestations and Course of the Disease , A.M.A. Arch. Intern. Med. 94:911-924, 1954.Crossref 7. Grönblad, E.: Angioid Streaks: Pseudoxanthoma Elasticum; vorläufige Mitteilung , Acta Ophthal. 7:329, 1929.Crossref 8. Strandberg, J.: Pseudoxanthoma Elasticum , Zbl. Haut. Geschlechtskr. 31:689, 1929. 9. Robertson, M. G., and Schroder, J. S.: Pseudoxanthoma Elasticum , Amer. J. Med. 27:433-442, 1959.Crossref 10. Kaplan, L., and Hartman, S. W.: Elastica Disease: Case of Grönblad-Strandberg Syndrome with Gastrointestinal Hemorrhage , A.M.A. Arch. Intern. Med. 94:489-492, 1954.Crossref 11. Woo, J. C., Jr., and Chandler, F. W.: Pseudoxanthoma Elasticum with Gastric Hemorrhage: Re-Report of a Case , Ann. Intern. Med. 49:215-222, 1958.Crossref 12. Carlborg, U.; Ejrup, B.; Grönblad, E., and Lund, F.: Vascular Studies in Pseudoxanthoma Elasticum and Angioid Streaks , Acta Med. Scand. Suppl. 350, 1959. 13. Weber, J. M.; Nash, E. C., and Gregg, L. A.: Hemorrhage from the Upper Gastrointestinal Tract: Report of 300 Cases and Discussion of Treatment , J.A.M.A. 165:1899-1905, 1957.Crossref 14. Schiff, L.: Hematemesis and Melena , Clinics 2:1542-1567, 1944. 15. Crohn, B. B.; Marshak, R. H., and Galinsky, D.: Repeated Gastroduodenal Hemorrhages Without Discoverable Explanation , Gastroenterology 10:120-128, 1948. 16. Gott, J. R., Jr.; Smith, E. L., and Dornan, D. D.: Acute Severe Upper Gastrointestinal Hemorrhage: A Review of 195 Cases , Ann. Intern. Med. 36:1001-1016, 1952.Crossref 17. Welch, C. E.: Treatment of Acute, Massive Gastroduodenal Hemorrhage , J.A.M.A. 141:1113-1110, 1949.Crossref 18. Costello, C.: Massive Hematemesis: Analysis of 300 Consecutive Cases , Ann. Surg. 129:289-298, 1949.Crossref 19. Dooley, B. N.; Gorden, W. B., and Tuttle, L. L. D.: Massive Gastrointestinal Hemorrhage of Undetermined Origin , Amer. J. Surg. 94:718-722, 1957.Crossref 20. Hoffman, F. G.; Zimmerman, S. L., and Cardwell, E. S., Jr.: Massive Intestinal Infarction Without Vascular Occlusion Associated with Aortic Insufficiency , New Engl. J. Med. 263:436, 1960.Crossref

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Archives of Internal Medicine – American Medical Association

Published: Dec 1, 1961

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