Heart failure secondary to severe anemia in beta-thalassemia major: a case report

Authors

  • Aswathy Mathews Department of Medicine, Sivagangai Medical College, Sivagangai, Tamil Nadu, India
  • Amal Prazad Department of Interventional Radiology, Marreita Memorial Hospital, Ohio, USA
  • Bharath Duraisamy Swami Kannan Department of Internal Medicine, Sivagangai Medical College, Sivagangai, Tamil Nadu, India
  • Dinesh Kumar Shanmugam Department of Medicine, PSG Institute of Research and Medical Sciences, Coimbatore, Tamil Nadu, India
  • Lakshiya Ramamoorthy Department of Medicine, Madras Medical College, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20242669

Keywords:

Beta-thalassemia, Anaemia, Congestive heart failure, Hypoxia

Abstract

The profile of cardiac involvement in beta-thalassemia major patients in the absence of significant cardiac iron overload is quite rare. This case report focuses on a 3-year-old child with a history of beta-thalassemia who presented with acute heart failure following missed blood transfusions, despite consistent chelation therapy. Clinical evaluation revealed severe anaemia, and cardiac ischemia leading to cardiovascular compromise, despite desirable ferritin levels. The patient's condition improved with guideline-directed medical therapy, transfusions, and continued chelation. We hypothesize that tissue hypoxia plays a significant role in the development of cardiac ischemia leading to heart failure, highlighting the critical importance of adherence to treatment schedules to prevent severe complications.

References

Sharma DC, Arya A, Kishore P, Woike P, Bindal J. Overview on thalassemias: A review article. Medico Res Chronicles. 2017;4:325-37.

Galanello R, Origa R. Beta-thalassemia. Orphanet J Rare Dis. 2010;5:11.

Kremastinos DT, Farmakis D, Aessopos A, Hahalis G, Hamodraka E, Tsiapras D, et al. Beta-thalassemia cardiomyopathy: history, present considerations, and future perspectives. Circ Heart Fail. 2010;3(3):451-8.

Hahalis G, Alexopoulos D, Kremastinos DT, Zoumbos NC. Heart failure in beta-thalassemia syndromes: a decade of progress. Am J Med. 2005;118(9):957-67.

Farmakis D, Triposkiadis F, Lekakis J, Parissis J. Heart failure in haemoglobinopathies: pathophysiology, clinical phenotypes, and management. Eur J Heart Fail. 2017;19(4):479-89.

Shahramian I, Razzaghian M, Ramazani AA, Ahmadi GA, Noori NM, Rezaee AR. The Correlation between Troponin and Ferritin Serum Levels in the Patients with Major Beta-Thalassemia. Int Cardiovasc Res J. 2013;7(2):51-5.

Akiki N, Hodroj MH, Bou-Fakhredin R, Matli K, Taher AT. Cardiovascular complications in β-thalassemia: Getting to the heart of it. Thalass Rep. 2023;13(1):38-50.

Saliba AN, Taher AT. Morbidities in non-transfusion-dependent thalassemia. Ann N Y Acad Sci. 2016;1368(1):82-94.

Isa Tafreshi R, Radgoodarzi M, Arjmandi Rafsanjani K, Soheilipour F. Subclinical Left Ventricular Dysfunction in Children and Adolescence With Thalassemia Intermedia. Front Pediatr. 2022;10:774528.

Mozos I. Mechanisms linking red blood cell disorders and cardiovascular diseases. Biomed Res Int. 2015;2015:682054.

Farmakis D, Porter J, Taher A, Domenica Cappellini M, Angastiniotis M, Eleftheriou A. 2021 Thalassaemia International Federation Guidelines for the Management of Transfusion-dependent Thalassemia. Hemasphere. 2022;6(8):e732.

Olivieri NF, Nathan DG, MacMillan JH, Wayne AS, Liu PP, McGee A, et al. Survival in medically treated patients with homozygous beta-thalassemia. N Engl J Med. 1994;331(9):574-8.

Munkongdee T, Chen P, Winichagoon P, Fucharoen S, Paiboonsukwong K. Update in Laboratory Diagnosis of Thalassemia. Front Mol Biosci. 2020;7:74.

Fridlender ZG, Rund D. Myocardial infarction in a patient with beta-thalassemia major: first report. Am J Hematol. 2004;75(1):52-5.

Maleki AR, Nikyar B, Hosseini SM. Third-Degree Heart Block in Thalassemia major: A Case Report. Iran J Pediatr. 2012;22(2):260-4.

Politi A, Sticca M, Galli M. Reversal of haemochromatotic cardiomyopathy in beta thalassaemia by chelation therapy. Br Heart J. 1995;73(5):486-7.

Downloads

Published

2024-09-11

How to Cite

Mathews, A., Prazad, A., Kannan, B. D. S., Shanmugam, D. K., & Ramamoorthy, L. (2024). Heart failure secondary to severe anemia in beta-thalassemia major: a case report. International Journal of Research in Medical Sciences, 12(10), 3907–3910. https://doi.org/10.18203/2320-6012.ijrms20242669

Issue

Section

Case Reports