Fast Five Quiz: Iron Deficiency and Anemia in Heart Failure

Arnold S. Baas, MD; Jeff Hsu, MD


March 15, 2021

Intestinal edema may be an important cause of absolute iron deficiency (when total body iron is decreased) in patients with heart failure because it leads to impaired iron absorption. Absolute iron deficiency can also result from cardiac cachexia; anorexia; or hepcidin-induced downregulation of iron transporters, such as ferroportin.

Gastrointestinal blood loss related to use of aspirin, antiplatelet agents, or anticoagulants is another potential cause of absolute iron deficiency. In men and postmenopausal women presenting with iron deficiency anemia, an endoscopic evaluation to exclude bleeding gastrointestinal lesions is warranted.

Both absolute and functional iron deficiency in heart failure can occur simultaneously in the same patient and are relatively common findings in patients with heart failure, even among those who have undergone heart transplantation.

Learn more about heart failure.


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