A patient with heart failure may experience anemia for many reasons. The presence of anemia is associated with a poor outcome in patients with heart failure.

Secondary causes of anemia:

(1) iron deficiency

(2) folate and/or vitamin B12 deficiency

(3) drug toxicity

(4) depressed erythropoietin production secondary to chronic renal disease

(5) anemia of chronic disease

(6) myelodysplasia

(7) bleeding

Correcting the underlying cause can often correct the anemia.


In addition, there is evidence of bone marrow dysfunction in patients with heart failure, associated with a poor response to erythropoietin. All 3 lineages are affected. Hematopoietic stem cells show reduced proliferation, maturation and function.

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