EVALUATION OF GLOBAL LONGITUDINAL STRAIN IN HEART FAILURE WITH PRESERVED EJECTION FRACTION CAUSED BY SEVERE ANEMIA

Akhil Mehrotra*, Mohammed Shaban

Iron deficiency anemia (IDA), a prevalent blood disorder, arises from insufficient iron reserves that hinder adequate red blood cell production, leading to reduced hemoglobin levels and compromised oxygen delivery. This condition is more common in women and is associated with a stronger impact on left ventricular mass. Severe cases often result in elevated left ventricular mass with eccentric hypertrophy being more frequent. Echocardiography reveals hemodynamic alterations linked to IDA, which can enhance oxygen delivery. Severe IDA may also cause an elevated heart rate and increased stroke volume, thereby raising cardiac output. Assessment of left ventricular (LV) global longitudinal strain (GLS) via speckle tracking echocardiography (STE) offers a non-invasive, cost-effective method to quantitatively evaluate early declines in LV systolic function among IDA patients. STE, being non-invasive, affordable, and widely used in clinical settings, could serve as a practical tool for assessing GLS in severe anemia cases, as impaired GLS may signal silent myocardial dysfunction. Speckle tracking technology can detect cardiac involvement at very early stages. A delicate boundary exists between overt myocardial dysfunction and asymptomatic LV dysfunction in severely anemic individuals. Thus, advanced imaging techniques are essential to identify subtle cardiac changes in the initial phases. We present a case of a teenage male with severe anemia complicated by heart failure with preserved ejection fraction (HFpEF), where detailed 2D echocardiography, including GLS analysis via STE, was conducted.