{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:21:22Z","timestamp":1788182482674,"version":"build-2803163510"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>Heyde\u2019s syndrome is a recognized but often underdiagnosed cause of recurrent gastrointestinal bleeding in elderly patients, characterized by the triad of severe aortic stenosis, gastrointestinal angiodysplasia, and acquired von Willebrand factor (vWF) deficiency. We report the case of a 72-year-old male who presented with recurrent melena over 6 months, associated with progressive anemia and fatigue. Despite multiple hospitalizations and repeated upper gastrointestinal endoscopy and colonoscopy, no bleeding source was identified. Further evaluation revealed severe calcific aortic stenosis on echocardiography and evidence of acquired vWF deficiency. Capsule endoscopy identified angiodysplasia in the proximal jejunum. The patient was initially managed with supportive and endoscopic measures; however, due to persistent bleeding, he underwent surgical aortic valve replacement. Following valve replacement, gastrointestinal bleeding resolved completely, hemoglobin levels normalized, and vWF multimers were restored. This case highlights the importance of recognizing the diagnostic triad of Heyde\u2019s syndrome and supports aortic valve replacement as definitive therapy.<\/jats:p>","DOI":"10.4103\/jcecho.jcecho_20_26","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T15:00:51Z","timestamp":1784559651000},"page":"485-487","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Recurrent Gastrointestinal Bleeding in Severe Aortic Stenosis: A Case of Heyde\u2019s Syndrome"],"prefix":"10.4103","volume":"36","author":[{"given":"Prajakta","family":"Kakde","sequence":"first","affiliation":[{"name":"Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vangala Uday","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shourya","family":"Acharya","sequence":"additional","affiliation":[{"name":"Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saket Satyasham","family":"Toshniwal","sequence":"additional","affiliation":[{"name":"Department of Cardiology, D. Y. Patil School of Medicine, Navi Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anusha","family":"Jha","sequence":"additional","affiliation":[{"name":"Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"R1-20260831","first-page":"e41468","article-title":"Recurrent gastrointestinal bleeding in an elderly patient with peptic ulcer disease: Successful management through multidisciplinary intervention and close monitoring","volume":"15","author":"Ahmad","year":"2023","journal-title":"Cureus"},{"key":"R3-20260831","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1055\/s-0037-1599145","article-title":"Angiodysplasia in von Willebrand disease: Understanding the clinical and basic science","volume":"43","author":"Selvam","year":"2017","journal-title":"Semin Thromb Hemost"},{"key":"R4-20260831","doi-asserted-by":"crossref","first-page":"1704","DOI":"10.3390\/cancers16091704","article-title":"Endoscopic diagnosis of small bowel tumor","volume":"16","author":"Yano","year":"2024","journal-title":"Cancers (Basel)"},{"key":"R5-20260831","doi-asserted-by":"crossref","first-page":"16","DOI":"10.5946\/ce.2016.49.1.16","article-title":"The role of capsule endoscopy in patients with obscure gastrointestinal bleeding","volume":"49","author":"Min","year":"2016","journal-title":"Clin Endosc"},{"key":"R6-20260831","doi-asserted-by":"crossref","first-page":"483","DOI":"10.4065\/mcp.2009.0706","article-title":"Valvular heart disease: Diagnosis and management","volume":"85","author":"Maganti","year":"2010","journal-title":"Mayo Clin Proc"},{"key":"R7-20260831","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.hrtlng.2010.07.004","article-title":"Aortic stenosis and angiodysplastic gastrointestinal bleeding: Heyde\u2019s disease","volume":"41","author":"Islam","year":"2012","journal-title":"Heart Lung"},{"key":"R8-20260831","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1093\/gastro\/gou025","article-title":"Small bowel bleeding: A comprehensive review","volume":"2","author":"Gunjan","year":"2014","journal-title":"Gastroenterol Rep (Oxf)"},{"key":"R9-20260831","doi-asserted-by":"crossref","first-page":"1159894","DOI":"10.3389\/fcvm.2023.1159894","article-title":"Shear-induced acquired von Willebrand syndrome: An accomplice of bleeding events in adults on extracorporeal membrane oxygenation support","volume":"10","author":"Wang","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"R10-20260831","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1177\/000331978403500807","article-title":"Angiodysplasia of the colon in patients with hemostatic defects: Risk of secondary hemorrhage after electrocoagulation treatment","volume":"35","author":"Bell","year":"1984","journal-title":"Angiology"},{"key":"R11-20260831","doi-asserted-by":"crossref","first-page":"7319","DOI":"10.12998\/wjcc.v9.i25.7319","article-title":"Aortic stenosis and Heyde\u2019s syndrome: A comprehensive review","volume":"9","author":"Lourdusamy","year":"2021","journal-title":"World J Clin Cases"},{"key":"R12-20260831","doi-asserted-by":"crossref","first-page":"101639","DOI":"10.5492\/wjccm.v14.i1.101639","article-title":"Management of gastrointestinal bleed in the intensive care setting, an updated literature review","volume":"14","author":"Nagesh","year":"2025","journal-title":"World J Crit Care Med"},{"key":"R13-20260831","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.thromres.2016.12.027","article-title":"Transcatheter aortic valve implantation leads to a restoration of von Willebrand factor (VWF) abnormalities in patients with severe aortic stenosis \u2013 Incidence and relevance of clinical and subclinical VWF dysfunction in patients undergoing transfemoral TAVI","volume":"151","author":"Sedaghat","year":"2017","journal-title":"Thromb Res"}],"container-title":["Journal of Cardiovascular Echography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jcecho.jcecho_20_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:01:01Z","timestamp":1788181261000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jcecho.jcecho_20_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,24]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jcecho.jcecho_20_26","relation":{},"ISSN":["2211-4122","2347-193X"],"issn-type":[{"value":"2211-4122","type":"print"},{"value":"2347-193X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,24]]},"assertion":[{"value":"2026-02-12","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-30","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}