Bailistocardiographic Study in Severe Anemia

ANEMIA affects the heart by impairing the oxygen supply of the myocardium and by increasing the mechanical load on the heart through alterations in the circulatory dynamics. Irrespective of the cause of anemia, the cardiac and circulatory disturbances are identical as long as the anemia is severe. With the introduction of ballistocardiographic technics, a new tool became available for the study of the force of cardiac contractions in various disease states; this technic, however, has not been adequately exploited to investigate the cardiac changes in anemia. Dock and his colleagues' made only casual references to the ballistocardiographic changes in anemia, stating that the tracings showed high-amplitude waves indicating increased force of cardiac contraction. They noted that the correction of anemia caused a reversion of the highamplitude waves toward normal. In a study of severely anemic patients, Sanghvi and Banerjee2 noted abnormal tracings in every case, the abnormalities consisting of tall or bifid H; fused HJ; broad or bifid J; short, absent, or notched K; tall L, M, or N; and totally bizarre complexes of low amplitude. In a third of their cases, large systolic complexes were seen, and the pattern was grossly abnormal in few of these. In significant contrast to the high-amplitude waves, totally bizarre complexes of small amplitude and grade-IV abnormality were seen in the minority of cases. These authors noted that, in the vast majority of cases, ballistocardiographic abnormalities persisted even after the cure of anemia and that the degree of abnormality often remained unaltered by the correction of anemia. In order further to document the ballistocardiographic changes, a study of 10 cases of severe anemia is reported.