File:Heydes Syndrome Pathophysiology.svg

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Summary

Description
English: The pathophysiology of acquired von Willebrand's Disease type 2A (vWD-2A) from an aortic stenosis (Heyde's Syndrome).

a. von Willebrand Factor (vWF) passes through a normal aortic valve and remains in its coiled high molecular weigh form.
b. vWF passes through a stenotic aortic valve and uncoils due to the high shear stress.
c. Coiled vWF is unaffected by the catabolic enzyme ADAMTS13, and passes into regular circulation via the aorta.
d. Uncoiled active vWF is cleaved in two by ADAMTS13 and becomes nonfunctional.
e. In small damaged arterioles with high shear stress vWF uncoils and becomes active. It then binds to the collagen on the other side of the damaged arteriole wall. Platelets bind to vWF and release a cytokine signal that activates other clotting factors resulting in more platelet binding and the formation of a clot; bleeding stops.

f. Inactive cleaved vWF cannot bind to the collagen, and due to the high blood flow, the platelets also fail to bind (they need vWF to do so), as such a small arteriole bleed continues unabated.
Date
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Author Michael D. Dacre
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I, the copyright holder of this work, hereby publish it under the following license:
w:en:Creative Commons
attribution share alike
This file is licensed under the Creative Commons Attribution-Share Alike 4.0 International license.
You are free:
  • to share – to copy, distribute and transmit the work
  • to remix – to adapt the work
Under the following conditions:
  • attribution – You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
  • share alike – If you remix, transform, or build upon the material, you must distribute your contributions under the same or compatible license as the original.

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inception

9 July 2015

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Date/TimeThumbnailDimensionsUserComment
current21:28, 10 July 2015Thumbnail for version as of 21:28, 10 July 2015787 × 1,070 (6.47 MB)wikimediacommons>MikeDacreImproved high resolution version of vWF with help from alexdon, added 'zoom' box for clarity

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