Treatment of Anaemia with Heart Failure

Anaemia reduces the blood’s oxygen-carrying capacity, while heart failure limits how effectively the heart circulates blood. Together they may worsen fatigue, breathlessness, palpitations or reduced exercise tolerance. Swollen ankles and cough can also reflect fluid congestion from heart failure. Symptoms overlap, so a clinician needs to assess both rather than assume one diagnosis explains every change.

Arrange a clinical review for blood tests, medication review and assessment of fluid status. Treatment depends on the cause of anaemia and the type of heart failure; it may involve correcting a deficiency, addressing blood loss, treating kidney or inflammatory problems, and optimising heart-failure medicines. Do not start iron, stop diuretics or change cardiac medicines without advice. Keep a record of breathlessness, weight changes, swelling and activity tolerance.

Seek emergency help for severe breathlessness at rest, chest pain, fainting, new confusion, blue lips, coughing up pink froth, or a very fast or irregular heartbeat with weakness. Contact your care team promptly for rapidly increasing ankle swelling, sudden weight change, worsening fatigue or a cough that is new or more troublesome.

What is causing my anaemia, and which tests are needed? Could any medicine be worsening it or my fluid balance? What symptoms should I record before my next Chronic Disease Review, and who should I contact if they worsen?