Iron deficiency is a well-known cause of anemia. However, it is an under-recognized cause of venous thromboembolism (VTE). Iron deficiency predisposes to VTE mainly by inducing thrombocytosis, which can lead to a hypercoagulable state. Identifying iron deficiency as a possible cause of thromboembolic phenomena has clinical significance since this is a potentially avoidable risk factor. This case report serves as a reminder that iron deficiency is an important risk factor for VTE that should be considered in the evaluation of patients. This is particularly true in patients like ours who have recurrent venous thromboembolic disease.

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The development of the cardiac pacemaker represents one of the most important advances in modern medicine, saving and improving many lives for over 60 years. It is increasingly apparent, however, that the benefits of cardiac pacing have been unevenly applied across the globe, with implantation rates in many low-and middle-income countries (LMICs) 10-100 times lower than in the United States, Canada, and western Europe. 8 This disparity suggests that many thousands of deaths and much preventable morbidity from bradycardia may be occurring in these nations. The high cost of permanent pacemaker hardware is one major barrier to greater pacemaker utilization, and pacemaker reuse has been suggested as one potential solution. 9