Suspect Iron Deficiency in HF

FINDING IRON DEFICIENCY CAN BE OBVIOUS WHEN YOU KNOW WHAT TO LOOK FOR

Routine blood tests are important and strongly recommended to ensure proper diagnosis1

Because heart failure (HF) symptoms can look like iron deficiency (ID) and iron deficiency anemia (IDA), it’s important to obtain lab values for key iron deficiency indices.2-4

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2022 AHA/ACC/HFSA GUIDELINES SPOTLIGHT

Latest guidelines recommend that all patients with HF have complete blood count, ferritin, serum iron, and transferrin saturation (TSAT) be tested as part of baseline laboratory assessments.1

When it comes to diagnosing iron deficiency in heart failure, look for:

  • FERRITIN LEVELS BELOW 100 μg/L1 OR
  • FERRITIN LEVELS OF 100 μg/L TO 300 μg/L, IF TSAT IS <20%1

Can you I.D. ID?

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Iron deficiency in patients with HF, with or without anemia, may be overlooked because HF and ID share many of the same signs and symptoms.3-5 Select whether each of the following belongs to HF, ID, or BOTH. Correct answers will appear in yellow.

Dyspnea
HF
ID
Both
Persistent cough
HF
ID
Both
Edema*
HF
ID
Both
Fatigue
HF
ID
Both
Pica
HF
ID
Both
Heart palpitations
HF
ID
Both

*In severe anemia.6

If you notice your patient with heart failure experiencing one or more of the symptoms of iron deficiency, check their iron levels.1

 

Additional comorbidities, such as chronic kidney disease (CKD), cardiac cachexia-associated poor nutritional status, and low albumin can worsen outcomes when present in patients already suffering from HF and anemia.2

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THE IMPACT OF TREATING ID CAN BE OBVIOUS

Iron deficiency can have an impact on postdischarge outcomes. One major aim of treatment optimization for patients with HF is to treat comorbidities, including iron deficiency.1,5

Go to: Treatment
References: 1. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2022;79(17):e263-e421. doi.org/10.1016/j.jacc.2021.12.012 2. Anand IS, Gupta P. Anemia and iron deficiency in heart failure: current concepts and emerging therapies. Circulation. 2018;138(1):80-98. doi:10.1161/CIRCULATIONAHA.118.030099 3. Dumitru I. Heart failure clinical presentation. Medscape. Updated March 2, 2021. Accessed April 13, 2021. http://emedicine.medscape.com/article/163062-clinical 4. Top Doctors®, United Kingdom. Iron Deficiency. Accessed June 29, 2022. https://www.topdoctors.co.uk/medical-dictionary/iron- deficiency# 5. Lam CSP, Doehner W, Comin-Colet J; IRON CORE Group. Iron deficiency in chronic heart failure: case-based practical guidance. ESC Heart Fail. 2018;5(5):764-771. doi:10.1002/ehf2.12333 6. Anand IS, Chandrashekhar Y, Ferrai R, Poole-Wilson PA, Harris PC. Pathogenesis of oedema in chronic severe anemia: studies of body water and sodium, renal function, haemodynamic variables, and plasma hormones. Br Heart J. 1993;70:357-362.