Patients with Native Cardiovascular Disease and Implantable Cardiac Devices

Cardiovascular disease is common in the adult population and has been well associated with gastrointestinal bleeding. Cardiac valvular disease, in particular, is often associated with gastrointestinal bleeding and poses its own set of diagnostic and therapeutic challenges. One of the most common cardiovascular conditions associated with gastrointestinal bleeding is aortic stenosis, although bleeding has been described in all forms of stenotic and regurgitant valvular disease. The evolution of cardiac assist devices in the management of cardiovascular disease has also introduced new considerations for the practicing gastroenterologist, as gastrointestinal bleeding is one of the most common complications in patients with implantable cardiac assist devices. The gastrointestinal bleeding seen with cardiovascular disease can be chronic, difficult to diagnose, and resistant to conventional management. Consequently, it is important to understand both the mechanism of bleeding and the available treatments in order to best manage this unique form of gastrointestinal bleeding.