Discussion Forums > Thalassemia Major

Cardiac monitoring and treatment in thalassemia major

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jatin:
Hi everyone I want how to diagnosis early cardiac problem in thalassemia major as alone LVEF is not enough enough ..??
What's the treatment for cardaic complications as many cardaiclogist as not train to detect cardaic problem in thal and how to treat it
Thanks to all in advance

Andy Battaglia:
If cardiac problems beyond those that are caused by reversible iron overload are suspected, which can be detected by MRI, I believe that the patient should be investigated for any signs of pulmonary hypertension.

Pratik:
Andy, I've always had increased heart beats since several years now (I can't ever remember them being 70-80 anyway since I was child lol). Does that mean I have a chance for PHT? I don't have any other symptoms of it except increased heartbeats (90-105).

I however notice that they get better in the first week after I transfuse (stays around 90 or so mostly). So I guess all Thal majors mostly has this especially on the last few days before transfusion due to slightly lower hb?

Thanks,

-P

Andy Battaglia:
All transfusing patients are at risk of PHT. And as you observe, the lower the Hb, the harder the heart has to work. Antioxidants and nitric oxide fixers like carnitine and arginine can help prevent this, as will keeping the Hb higher.

Khwahish:
Hi Andy,you mentioned "the lower the Hb, the harder the heart has to work." Are there any medical journal articles published supporting this. I need to take them to my PHT Dr who has somehow been reluctant to take this into account when considering my course of treatment and giving her input into frequency of BTs.

Thanks.

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