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A woman in her 90s was referred to our hospital for further evaluation of anaemia. The patient had been receiving long-term oral iron supplementation before admission. On physical examination, she had conjunctival pallor. Physical examination revealed a grade 3/6 systolic murmur at the second right intercostal space radiating toward the right carotid artery. Digital rectal examination showed melena. Blood tests revealed a haemoglobin level of 63 g/L, a serum iron level of 107 µg/dL, a total iron-binding capacity of 361 µg/dL, a ferritin level of 46.4 ng/mL, a mean corpuscular volume of 100 fL, and a red cell distribution width of 16.1%. Transthoracic echocardiography showed a heavily calcified aortic bicuspid valve with aortic valve area of 0.74 cm2 and a mean aortic valve gradient of 50.2 mm Hg. Upper gastrointestinal endoscopy revealed gastric antral vascular ectasia, also known as watermelon stomach ( figure 1). The patient was treated with argon plasma coagulation (APC) (figure 2). The differential diagnosis includes hereditary haemorrhagictelangiectasia, portal hypertensive gastropathy related to cirrhosis, and gastrointestinal manifestations of systemic sclerosis. In the present case, severe aortic stenosis raised clinical suspicion for Heyde syndrome, although specific testing for acquired von Willebrand syndrome (vWF) was not performed. She was discharged with no progression of anaemia. At day 65 of follow-up, upper gastrointestinal endoscopy revealed improvement of the capillary telangiectasia (figure 3). She was referred for transcatheter aortic valve implantation (TAVI); however, after discussion with the patient, the procedure was postponed because she did not wish to undergo it.