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Can Anemia Cause Chest Pain?
Question: Hello,
I have been experiencing chest pain for the last 9 days which prompted me to go to my primary doctor. He did an Ekg and found that I had symptomatic bradycardia. I have uploaded my ekg for you to look at. My history is that I have Chronic anemia first diagnosed at the age of 3. Called Pure red cell aplaisia/Diamond blackfan syndrome. I have had transfusions when needed, but my hematologist prefers not to transfuse since it only temporarily helps. My Hemoglobin last checked was at 8. My blood pressure, always runs low as well. Today it was 98 over 57. I am not able to get into a cardiologist till next week and was told by my pcp that if I get chest pains to go to the ER. THis has me concerned now because I have been getting chest pains in varying degrees for the last 9 days. My questions are this:
1. My part time job requires me to walk at a moderate pace. Can this make my situation worse? More chance of fainting/chest pains ect?
2. Does my anemia of 8 make this situation worse since my heart is working harder to get more oxygen?
3. Since I have been having chest pains already, now that I know I have bradycardia, should I now not hesitate to go to the ER? I feel really stupid going for nothing. Is there a big concern of a having a heart attack? I have an appt with a gastro to see if this chest pain is a GI issue.
Thank you,
XXXX
4. Would a blood transfusion help to get more oxygen?
I have been experiencing chest pain for the last 9 days which prompted me to go to my primary doctor. He did an Ekg and found that I had symptomatic bradycardia. I have uploaded my ekg for you to look at. My history is that I have Chronic anemia first diagnosed at the age of 3. Called Pure red cell aplaisia/Diamond blackfan syndrome. I have had transfusions when needed, but my hematologist prefers not to transfuse since it only temporarily helps. My Hemoglobin last checked was at 8. My blood pressure, always runs low as well. Today it was 98 over 57. I am not able to get into a cardiologist till next week and was told by my pcp that if I get chest pains to go to the ER. THis has me concerned now because I have been getting chest pains in varying degrees for the last 9 days. My questions are this:
1. My part time job requires me to walk at a moderate pace. Can this make my situation worse? More chance of fainting/chest pains ect?
2. Does my anemia of 8 make this situation worse since my heart is working harder to get more oxygen?
3. Since I have been having chest pains already, now that I know I have bradycardia, should I now not hesitate to go to the ER? I feel really stupid going for nothing. Is there a big concern of a having a heart attack? I have an appt with a gastro to see if this chest pain is a GI issue.
Thank you,
XXXX
4. Would a blood transfusion help to get more oxygen?
Brief Answer:
Blood transfusion in case of normal heart function is not justied
Detailed Answer:
Hello XXXXXXX ,
I went through the information you have provided and would enlisted my recommendation.
1) The EcG is S. bradycardia. There is no evidence of ischemia on rest EKG you have done
2) An hemoglobin of 8 can surely cause angina ( demand - supply mismatch ) .
Two points against the same is .
a) There should be breathlessness while you exert rather than chest pain , Also if the heart arteries are normal and heart function is normal, generally hemoglobin of 8 doesn't cause angina
b) You must have always had hemoglobin on the lower side due to aphasia, So your body and heart is used to chronic anemia and so sudden onset of symptoms are not explained.
For transfusion should only be considered after other cause are ruled out
However in your case the hematologist is very right as transfusion has temporary role in your case and it as treatment of angina is not justified , unless heart is weak.
3) Any form of exercise increase requirement of oxygen and heart has to work more and so till your meeting with the cardiologist fo avoid exertion at work .
4) Bradycardia per say doesn't increase your risk of heart attack, However the cause of Bradycardia should be ruled out .
5) Visit ER of chest pain is associated with breathlessness, increase on activity or pain itself doesn't subside with rest .
My strong recommendation.
Evaluate the cause of bradycardia , Rule out hypothyroidism
Get and 2d Echo cardiogram done as you must have received a lot of transfusions aince the age of 3 years which puts you at risk of restrictive cardiomyopathy where the relaxation of the heart decrease causing symptoms you described. However Ecg doesn't point towards the same
Treadmill stress test will help yoir doctor to guide you for your work which involve moderate exercise.
Hopefully i could help .
Regards Dr Priyank Mody
Blood transfusion in case of normal heart function is not justied
Detailed Answer:
Hello XXXXXXX ,
I went through the information you have provided and would enlisted my recommendation.
1) The EcG is S. bradycardia. There is no evidence of ischemia on rest EKG you have done
2) An hemoglobin of 8 can surely cause angina ( demand - supply mismatch ) .
Two points against the same is .
a) There should be breathlessness while you exert rather than chest pain , Also if the heart arteries are normal and heart function is normal, generally hemoglobin of 8 doesn't cause angina
b) You must have always had hemoglobin on the lower side due to aphasia, So your body and heart is used to chronic anemia and so sudden onset of symptoms are not explained.
For transfusion should only be considered after other cause are ruled out
However in your case the hematologist is very right as transfusion has temporary role in your case and it as treatment of angina is not justified , unless heart is weak.
3) Any form of exercise increase requirement of oxygen and heart has to work more and so till your meeting with the cardiologist fo avoid exertion at work .
4) Bradycardia per say doesn't increase your risk of heart attack, However the cause of Bradycardia should be ruled out .
5) Visit ER of chest pain is associated with breathlessness, increase on activity or pain itself doesn't subside with rest .
My strong recommendation.
Evaluate the cause of bradycardia , Rule out hypothyroidism
Get and 2d Echo cardiogram done as you must have received a lot of transfusions aince the age of 3 years which puts you at risk of restrictive cardiomyopathy where the relaxation of the heart decrease causing symptoms you described. However Ecg doesn't point towards the same
Treadmill stress test will help yoir doctor to guide you for your work which involve moderate exercise.
Hopefully i could help .
Regards Dr Priyank Mody
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Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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