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Updated: Nov 10 2017

Macroangiopathic Anemia

5.0

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(3)

  • Introduction
    • RBCs are damaged in systemic circulation due to force delivered in large caliber vessels or the heart itself
    • Associated conditions
      • mechanical heart valves
      • calcified or stenotic heart valves
        • most commonly aortic valve
  • Presentation
    • Symptoms
      • anemia
        • fatigue
        • jaundice
        • pallor
        • shortness of breath
  • Evaluation
    • Labs
      • decreased Hgb
      • increased reticulocyte %
      • increased unconjugated bilirubin
      • increased LDH
      • decreased haptoglobin
    • Blood smear:
      • schistocytes (helmet cells)
        • due to shearing mechanical destruction
      • burr cells (echinocytes)
      • Normal platelet count
  • Treatment
    • Pharmacologic
      • chronic blood transfusions
        • indicated for anemic episodes
    • Operative
      • repair of defective valve OR replacement of previous prosthetic valve
        • indicated in severe cases
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