Circulatory Function in the Anemias of Children

Pathologic conditions of the myocardium are frequently reflected by alterations in the form of the electrocardiogram. In view of this, it is remarkable that only a few descriptions of electrocardiographic abnormalities associated with anemia have appeared. This is especially noteworthy if anoxemia plays an essential role in both anemia and coronary occlusion, for the latter condition yields one of the most distinctive of all electrocardiographic tracings. Severe anemia, especially if it is chronic, is recognized as a cause of myocardial damage. Pathologically, such damage is manifested by dilatation, hypertrophy or degeneration, changes generally conceded to be the result of oxygen starvation. Clinical evidence of damage is provided by gradual enlargement of the heart, the development of murmurs and occasionally, especially in adults, the onset of heart failure, either congestive or anginal.¹The fact that angina pectoris may be a complication of anemia²and may sometimes be relieved when