Anemia 6: Symtom Clinic

Clinical manifestation of anemia in heart occurred because the 3 factors that effect anoksemia against miokard, of heart disease and the previous high output. (Lefrandt R.L, 2004).
Diaspneu on exercise and palpitates is the main symptom. On more patients, dispneu usually only arise when doing exercise. But in a very serious anemia (3gr%) or with heart failure, dispneu can occur even in a state of rest. (Lefrandt R.L, 2004).
Angina due iskemia miokard often arise in patients who are older. Most patients suffering from anemia, which was then the previous angina also have a coronary stenosis in different levels, which in the circumstances without stenosis coroner anemia itself is not enough to cause a heart attack iskemik. (Lefrandt R.L, 2004).
Limit the rate of Hb rise to angina vary depending on the degree of coronary stenosis. So each angina attack occurred, Hb level should be determined, because if there is anemia factor as angina fuse, this should immediately be treated and usually reversible. Angina more affected coronary vessel condition of anemia itself. (Lefrandt R.L, 2004).

On physical examination the patient with anemia, found generally noisy, depending on the weight anemia. This can be noisy because of their own or because anemia organic heart disease or a combination of both. Haemic audible murmur as ejection soft mid systolic murmur, due to the speed of blood flow in the heart valve increase and be on the basis Apex or heart, or both. (Lefrandt R.L, 2004).
Diastolik noisy because anemia own rare. But the noisy diastolic be reported in the aorta in patients with anemia related anemia although not yet known. Anemia that can cause enlargement of the heart, this is usually because dilatasi miokard. In the chronicles of anemia that have been longstanding also hypertrophy heart. Haemic murmur is often found in young patients and usually disappear when anemia corrected, with the loss of heart enlargement. Noisy that do not disappear or diminish after only anemia corrected, usually caused by the existence of heart disease itself. Systolic arterial bruit over karotis also often heard on the anemia and can bilateral and disappears after anemia corrected. (Lefrandt R.L, 2004).
High output state occurred in a heavily marked anemia with clinical symptoms of Jugular Venous Pressure (JVP), which escalate with the pulse collapse, skin redness and capillary pulses positive. (Lefrandt R.L, 2004).
Failed heart congestive anemia frequently occurs in weight, especially on the parents who accompanied cardiovascular degenerative with the disease, without anemia are not enough to trigger symptoms of heart failure. Anemia is an aggravating factor for the occurrence of dekompesasi. Even so, a very serious anemia without heart disease can cause heart failure (heart failure), usually at miokard so that heart muscle is not able to work again to raise the additional rainfall heart. Symptoms usually include heart failure congestive, congestion pulmonary, a high JVP, hepatospleenomegali, edema perifer. However, mild edema in the legs and sometimes also occurs in patients with anemia ambulatory weight without heart failure. Some of the factors that drives the occurrence of edema include Retention of salt, increasing the pressure on the vein capillary temporary at the time of exercise and the possibility that capillary permeability's escalate. (Lefrandt R.L, 2004).
EKG examination in 30% of patients with Hb between 6 gr% showed changes. Usually found ST-segment depression and T wave is flat or inverted. When these changes are really due to anemia and not due to coronary heart disease, when the corrected image anemia will EKG normal again. (Lefrandt R.L, 2004).
On the EKG, usually visible enlargement of all heart and symmetrical room, accompanied by the movement systolic (systolic motion) that hiperkinetik from septum and ventricle left posterior wall, with the ejection fraction is still normal. (Lefrandt R.L, 2004).