Bradycardia and heart block are rarely reported in the parenteral iron literature. Although rare, it may be reasonable to consider parenteral iron as a toxicological etiology for patients presenting with complete heart block temporally associated with a parenteral iron infusion, particularly in patients with underlying conduction abnormalities.

In the case of ongoing clinical instability when other causes have been sufficiently ruled out and acute iron toxicity or chronic iron overload is suspected, consultation with the local poison control center for consideration of deferoxamine for iron chelation may be reasonable.

Ferric derisomaltose is the newest available parenteral iron formulation. Studies have demonstrated a good safety profile with improved tolerability compared to alternative parenteral iron formulations. To date there have been no reported acute, life-threatening cardiac events associated with ferric derisomaltose.

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