Effects of Anemia on Function of
the Circulatory System
The viscosity of the blood, depends almost entirely on the blood
concentration of red blood cells. In severe anemia, the blood viscosity may
fall to as low as 1.5 times that of water rather than the normal value of about
3. This decreases the resistance to blood flow in the periph-eral blood
vessels, so that far greater than normal quantities of blood flow through the
tissues and return to the heart, thereby greatly increasing cardiac output.
Moreover, hypoxia resulting from diminished trans-port of oxygen by the blood
causes the peripheral tissue blood vessels to dilate, allowing a further
increase in the return of blood to the heart and increasing the cardiac output
to a still higher level— sometimes three to four times normal. Thus, one of the
major effects of anemia is greatly increased
cardiacoutput, as well as increased
pumping workload on the heart.
The increased cardiac output in anemia partially offsets the
reduced oxygen-carrying effect of the anemia, because even though each unit
quantity of blood carries only small quantities of oxygen, the rate of blood
flow may be increased enough so that almost normal quantities of oxygen are
actually delivered to the tissues. However, when a person with anemia begins to
exercise, the heart is not capable of pumping much greater quantities of blood
than it is already pumping. Consequently, during exercise, which greatly
increases tissue demand for oxygen, extreme tissue hypoxia results, and acute cardiac failure ensues.
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