A case of heart failure and polycythemia: Treated with phlebotomy

Abstract

Polycythemia in heart failure (HF) is known but rarely encountered. A 76-year-old male presented with New York Heart Association Class III HF symptoms leading to secondary polycythemia. He had underlying ischemic cardiomyopathy not amenable to revascularization and thus was put on optimal medical therapy. However, after being refractory to medical management, he was treated with phlebotomy showing a significant improvement in his symptoms as well as a drop in hemoglobin level. Diagnostic algorithm and management of polycythemia related to HF are discussed.

Keywords

• heart failure
• phlebotomy
• polycythemia