The Cardiovascular System in Anemia

characteristic. Bamberger’ nearly a century ago pointed out that cardiac enlargement is found in many patients suffering from anemia. The extent to which the functional activity of the cardiovascular apparatus is affected by anemia, however, is not so generally appreciated. Changes in the heart and circulation develop in part in response to needs arising from the lack of hemoglobin and thus of oxygen per unit of blood, and in part as a result of the influence of the anemia on the heart itself. Rapid development of anemia is accompanied by shortness of breath, tachycardia, and pallor. Very severe anemia, if produced quickly, as after severe blood loss, results in shock. Here we deal with a failure of adjustments to the lack of oxygentransporting material as well as with the effects produced by a sharp reduction in total blood volume. In cases in which serious cardiac damage is already present,