What Are The Complications Of Thalassemia?

Congestive Heart Failure

Congestive heart failure is a common complication seen in individuals with thalassemia. Two mechanisms cause congestive heart failure in these patients. The anemia that occurs from thalassemia causes the heart to beat at an abnormally rapid rate in efforts to compensate for poor oxygen delivery. Over time, the heart itself becomes enlarged from working extremely hard. Most patients affected by this complication develop an impairment in the ability of the heart to empty blood from the left ventricle and pump it into the aorta. From the aorta, the blood goes to re-oxygenated tissues around the body. This impairment is often accompanied by dilation or stretching of one or both of the heart's ventricles. When the ventricles stretch, they become weaker than they should be. Once the dilation and functional impairment of the ventricles can no longer meet the body's need for blood supply, the patient has congestive heart failure. When individuals with thalassemia are treated, the treatment may result in an iron buildup in multiple organs throughout the body including the heart. This toxicity can also contribute to the development of congestive heart failure.

Iron Overload

Individuals with thalassemia are often treated with a regimen of blood transfusions to compensate for the lack of healthy red blood cells. Blood transfusions can cause an excess amount of iron in the body. Thalassemia patients may also develop iron overload when their small intestine tries to compensate for the disorder by absorbing too much iron from food. When iron is circulating in the blood around the body, it is bound to a protein called transferrin. The binding of iron to this protein ensures only the tissues that need the iron will actually receive it. This mechanism protects other tissues around the body from iron toxicity. When there is more iron in the blood than there is transferrin for it to bind with, the iron can enter any organ. When large amounts of iron enter the issues of an organ, the organ becomes toxic. Critical organs such as the liver, kidneys, pancreas, and heart are very sensitive to iron toxicity, and their tissues become damaged as a result of iron overexposure.