Mysterious Chronic Anemia Hidden by Atherothrombosis Management and Incomplete History

Abstract A female in her late seventies was admitted and treated for cardiovascular disease (CVD) but was found to have persistent microcytic anemia that had received little diagnostic attention. Her long-term aspirin use increased the risk of gastrointestinal bleeding and consequent iron deficiency anemia. Inadequate documentation and follow-up obscured the evolution of her comorbidities, complicating accurate diagnosis. This case explores whether the anemia was not merely a side effect of CVD management but a potential contributor to her cardiovascular presentation. The possibility of an undiagnosed malignancy as the underlying cause of chronic iron deficiency, particularly in elderly patients, should be considered. A comprehensive assessment of all coexisting conditions is crucial in managing chronic disease; neglecting one may worsen another. This report highlights the importance of thorough history-taking and vigilance for secondary causes of anemia in older patients with established CVD.