Aortic Stenosis and Unexplained Gastrointestinal Bleeding

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