Acquired Von Willebrand syndrome secondary to mitral and aortic regurgitation.

The association between aortic stenosis and gastrointenstinal bleeding due to acquired von Willebrand syndrome (AVWS) has been well established. We report a patient with AVWS from underlying severe endocarditis-associated aortic regurgitation and pre-existing mitral regurgitation. Cardiovascular disease-related AVWS occurs from a selective loss of the largest multimers of von Willebrand factor from high shear forces, and desmopressin leads to transient clinical improvement.