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Chronic anemia complicated by cardiac failure, pulmonary hypertension, and pericardial effusion: a case report

BACKGROUND: Worldwide, iron deficiency anaemia (IDA) is the most common cause of anaemia. Iron deficiency alone has an association with heart failure and pulmonary hypertension. Chronic iron deficiency anemia triggers various physiologic adjustments, leading to hyperdynamic circulation and enhanced...

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Autores principales: Yousaf, Muhammad, iIlahi, Memon, Bibi, Aisha, Elhassan, Hadeel, Sharif, Muhammad, Abid, Abdul Rehman, Omran, Maya Ali, Hassan, Arwa, Haroon, Khawaja Hassan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9906880/
https://www.ncbi.nlm.nih.gov/pubmed/36750883
http://dx.doi.org/10.1186/s13256-022-03686-z
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author Yousaf, Muhammad
iIlahi, Memon
Bibi, Aisha
Elhassan, Hadeel
Sharif, Muhammad
Abid, Abdul Rehman
Omran, Maya Ali
Hassan, Arwa
Haroon, Khawaja Hassan
author_facet Yousaf, Muhammad
iIlahi, Memon
Bibi, Aisha
Elhassan, Hadeel
Sharif, Muhammad
Abid, Abdul Rehman
Omran, Maya Ali
Hassan, Arwa
Haroon, Khawaja Hassan
author_sort Yousaf, Muhammad
collection PubMed
description BACKGROUND: Worldwide, iron deficiency anaemia (IDA) is the most common cause of anaemia. Iron deficiency alone has an association with heart failure and pulmonary hypertension. Chronic iron deficiency anemia triggers various physiologic adjustments, leading to hyperdynamic circulation and enhanced hypoxic pulmonary vasoconstriction. Those mechanisms may result in the development of high output cardiac failure and pulmonary hypertension; however, pericardial effusion remains a rare association. CASE PRESENTATION: A 44-year-old Nepalese man presented with fatigability and swollen ankles. Except for a hemorrhoidectomy 4 years ago, he had no comorbidities. Labs confirmed severe iron deficiency anemia (hemoglobin 1.8 grams per deciliter) likely secondary to hemorrhoids. An echocardiogram revealed high output cardiac failure, pericardial effusion, and severe pulmonary hypertension. He responded well to the correction of anemia and diuretics with the resolution of vascular complications. CONCLUSION: We report a unique presentation of chronic severe iron deficiency anemia complicated by heart failure, pulmonary hypertension, and pericardial effusion. We believe it to be the first-ever such case reported in the literature. These cardiovascular complications seem to result from internal homeostatic mechanisms against the chronic tissue hypoxemia observed in severe anemia. Furthermore, iron deficiency alone has an association with heart failure and pulmonary hypertension. After excluding other potential causes, we confirmed iron deficiency anaemia as the cause of those complications. The correction of anemia led to an excellent recovery without any sequelae. Our case report highlights the fact that management of such a case should be focused on underlying etiology rather than the complications.
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spelling pubmed-99068802023-02-08 Chronic anemia complicated by cardiac failure, pulmonary hypertension, and pericardial effusion: a case report Yousaf, Muhammad iIlahi, Memon Bibi, Aisha Elhassan, Hadeel Sharif, Muhammad Abid, Abdul Rehman Omran, Maya Ali Hassan, Arwa Haroon, Khawaja Hassan J Med Case Rep Case Report BACKGROUND: Worldwide, iron deficiency anaemia (IDA) is the most common cause of anaemia. Iron deficiency alone has an association with heart failure and pulmonary hypertension. Chronic iron deficiency anemia triggers various physiologic adjustments, leading to hyperdynamic circulation and enhanced hypoxic pulmonary vasoconstriction. Those mechanisms may result in the development of high output cardiac failure and pulmonary hypertension; however, pericardial effusion remains a rare association. CASE PRESENTATION: A 44-year-old Nepalese man presented with fatigability and swollen ankles. Except for a hemorrhoidectomy 4 years ago, he had no comorbidities. Labs confirmed severe iron deficiency anemia (hemoglobin 1.8 grams per deciliter) likely secondary to hemorrhoids. An echocardiogram revealed high output cardiac failure, pericardial effusion, and severe pulmonary hypertension. He responded well to the correction of anemia and diuretics with the resolution of vascular complications. CONCLUSION: We report a unique presentation of chronic severe iron deficiency anemia complicated by heart failure, pulmonary hypertension, and pericardial effusion. We believe it to be the first-ever such case reported in the literature. These cardiovascular complications seem to result from internal homeostatic mechanisms against the chronic tissue hypoxemia observed in severe anemia. Furthermore, iron deficiency alone has an association with heart failure and pulmonary hypertension. After excluding other potential causes, we confirmed iron deficiency anaemia as the cause of those complications. The correction of anemia led to an excellent recovery without any sequelae. Our case report highlights the fact that management of such a case should be focused on underlying etiology rather than the complications. BioMed Central 2023-02-07 /pmc/articles/PMC9906880/ /pubmed/36750883 http://dx.doi.org/10.1186/s13256-022-03686-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Yousaf, Muhammad
iIlahi, Memon
Bibi, Aisha
Elhassan, Hadeel
Sharif, Muhammad
Abid, Abdul Rehman
Omran, Maya Ali
Hassan, Arwa
Haroon, Khawaja Hassan
Chronic anemia complicated by cardiac failure, pulmonary hypertension, and pericardial effusion: a case report
title Chronic anemia complicated by cardiac failure, pulmonary hypertension, and pericardial effusion: a case report
title_full Chronic anemia complicated by cardiac failure, pulmonary hypertension, and pericardial effusion: a case report
title_fullStr Chronic anemia complicated by cardiac failure, pulmonary hypertension, and pericardial effusion: a case report
title_full_unstemmed Chronic anemia complicated by cardiac failure, pulmonary hypertension, and pericardial effusion: a case report
title_short Chronic anemia complicated by cardiac failure, pulmonary hypertension, and pericardial effusion: a case report
title_sort chronic anemia complicated by cardiac failure, pulmonary hypertension, and pericardial effusion: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9906880/
https://www.ncbi.nlm.nih.gov/pubmed/36750883
http://dx.doi.org/10.1186/s13256-022-03686-z
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