？Qué hacer cuando la anemia se interpone en la insuficiencia cardíaca crónica?

for many years we have known the pathophysiological consequences of anemia in the cardiovascular system. multicenter studies showed that it is an independent risk factor of mortality and morbidity in chronic heart failure, so its correction improves survival in these patients. it has a high prevalence, in some series approaches 60%. the causes of anemia in patients with chronic heart failure are numerous and are often associated as mixed aetiological forms; these makes difficult our reach to a diagnosis and then find the specific treatment. therapeutic resources available are transfusion, intravenous iron and erythropoietin with its derivatives; all with potential unwanted effects. it is not clearly defined the minimum threshold of hemoglobin where increases mortality or the point where we should start working. and it is not defined how far carrying hemoglobin levels to avoid unwanted effects of therapy. for all these reasons, anemia is a real problem for the cardiologist. while we can now define some guidelines like: rule out common causes of anemia (gastrointestinal losses), evaluate iron deposits and use erythropoietin in a select group of patients, there is still no consensus on the heart failure guidelines.