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Approach to Von Willebrand disease (VWD)

By Matthew Ho, MD PhD @MatthewHoMD

#VWD #Von #Willebrand #VonWillebrand #disease #hematology
Willebrand disease (VWD ... MatthewHoMD #VWD ... Von #Willebrand #VonWillebrand
Acquired von Willebrand Syndrome - Diagnosis and Management
 • Autoantibodies to vWF: Lymphoproliferative disorders (e.g. lymphoma,
Autoantibodies to vWF ... Autoimmune disease • vWF ... #Acquired #vonWillebrand
Echocardiogram and POCUS Cardiology Windows and Anatomy
 • Parasternal Long Axis (PLAX)
 • Subcostal 4 Chamber
Subcostal 4 Chamber (S4C ... Apical 4 Chamber (A4C ... Apical 2 Chamber (A2C
POCUS Echocardiography - Table of Cardiac Views and Windows
 • Parastemal Long-Axis View (PLAX)
 • Parasternal
-Chamber View (A4C ... -Chamber View (A5C ... -Chamber View (A2C ... -Chamber View (A3C
Von Willebrand Disease - Clinical Presentation, Diagnosis and Management

- Dr. Eric Strong @DrEricStrong - Strong Medicine
EricsMedicalLectures/ #VonWillebrand
Platelet disorders and Aggregometry
Glanzmann Thrombasthenia
 • Defective aggregation to all agonists except ristocetin
 • Normal platelet,
also be seen in vWD ... differentiate vWD ... BS by measuring vWF
Stroke Volume & Cardiac Output Measurement on POCUS
Accurately measure LVOT diameter:
1. Obtain PLAX 
2. Zoom to
Obtain A5c view ... Run PWD trace 4 ... Trace around PWD
Cardiac Valve Replacement - Anticoagulation INR Targets and Antiplatelet by Valve Type

Bioprosthetic valves require at least
monotherapy (2017 AHA/ACC ... VHD Guidelines) ... valve (2017 AHA/ACC ... VHD Guidelines
Bleeding manifestations 
Petechiae are small, flat, red, discrete areas of skin bleeding that are typically <2
Diagnosis VWF ... (Quantity of VWF ... considered to be low) VWF ... of this plasma VWF ... (differentiate VWD
Von Willebrand Disease - Most common inherited bleeding disorder 
Clinical 
 • Easy bruising 
 •
Desmopressin (DDAVP) #VonWillebrand