STUDIES OF THE CIRCULATION IN PERNICIOUS ANEMIA 12

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Abstract
Cardiac output and related circulatory functions were measured in 5 cases of pernicious anemia both during the period of anemia and during a remission induced by liver therapy. During the anemia the heart increased its output per minute, the output bearing a linear relationship to the Hb. conc. The increased output was attained by increasing its rate as well as its output per beat. The arm to tongue circulation time was shortened, the red blood cells moving at an increased velocity. The O consumption was increased. The shortening of the circulation time and increase in cardiac output as well as decrease in Hb. and increase in 0 consumption, respectively, also appeared to have linear relationships. It appears that the heart, already working at an accelerated rate, is put to the disadvantage of having to maintain a circulation sufficient for the requirements of an increased basal metabolic rate. With increase in the level of Hb., changes in the reverse direction occur. The work of the left ventricle per beat was calculated; the hearts of all these patients, without congestive heat failure, at rest, mechanically perform the work expected of them in spite of the low Hb. values observed.