Patients with congestive heart failure (CHF) may have an associated problem of anemia, a decrease in the number of red blood cells (RBC) – the component of blood that carries oxygen. Even by itself, anemia can cause symptoms of shortness of breath and fatigue, similar to the symptoms of heart failure. A low RBC count (hematocrit) limits the amount of oxygen being carried to the body, which makes the heart work harder. In fact, as the severity of CHF progresses, the findings of anemia increase; and severe anemia due to any cause can worsen CHF. Because of this relationship, anemia treatment may be an important part of CHF.

Two medications, erythropoietin and darbepoetin alfa, stimulate RBC growth and production in the bone marrow. These medicines require being given by a shot (like insulin) usually every 1-4 weeks. This can help people with heart failure correct their anemia, when it is due to inadequate bone marrow production.

In general, severe anemia may also be treated with vitamins or blood transfusions.