Resolution of Acquired von Willebrand Disease Secondary to Hypertrophic Obstructive Cardiomyopathy Following Septal Myectomy.

  • Johnathan Hoggarth
  • Harry Rakowski Department of Cardiology, Peter Munk Cardiac Center University Health Network, Toronto General Hospital, Toronto, Ontario Canada
  • Erik Yeo Department of Haematology University Health Network, Toronto General Hospital, Toronto, Ontario Canada
  • Anthony Ralph-Edwards Department of Cardiovascular Surgery University Health Network, Toronto General Hospital, Toronto, Ontario Canada

Abstract

We report the case of a patient with hypertrophic obstructive cardiomyopathy, severe gastrointestinal bleeding and acquired von Willebrand syndrome. Pre-operative blood tests showed normal von Willebrand factor activity with decrease of high molecular weight multimers. Septal myectomy was performed in treatment of his hypertrophic disease. Follow-up blood tests indicated normal von Willebrand factor activity and high molecular weight multimers levels. Gastrointestinal bleeding has not recurred following surgery. In conclusion, septal myectomy resolves von Willebrand syndrome secondary to hypertrophic obstructive cardiomyopathy. von Willebrand factor Multimer testing can be used for the diagnosis of acquired von Willebrand syndrome which should be considered in patients who have gastrointestinal bleeding coinciding with hypertrophic obstructive cardiomyopathy.

Published
2017-05-31
Section
Case and Elective Reports