Fatty infiltration within chronic myocardial infarctions (MI) is a common finding. It is typically observed in the peri-infarct border zone of old scars and has been linked to adverse outcomes in the chronic post-MI setting. To date, the trigger for fat deposition within old MI is unknown. Recent reports showed that iron deposits from hemorrhagic MI drive the recruitment of new monocytes/macrophages into the infarcted territory throughout the chronic phase after MI. Since iron-laden macrophages (siderophages) are prone to transforming into foam cells, we hypothesized that fatty degeneration of hemorrhagic myocardial infarctions has its origin in iron-driven foam cell formation.