What should be included in a patient summary sheet for someone with iron deficiency anemia and cardiovascular disease, who is undergoing treatment and needs to visit a renowned cardiovascular center?

Summary Sheet for Cardiovascular Center Referral

Yes, a comprehensive summary sheet can and should be developed for your cardiovascular center visit. The summary should be a concise, single-page document that includes your current diagnoses, key laboratory values (especially hemoglobin, ferritin, and transferrin saturation), current medications with doses, recent hospitalizations, functional status (NYHA class), and specific treatment responses—particularly your response to intravenous iron therapy if you've received it. 1

Essential Components to Include

Primary Diagnoses Section

• Cardiovascular disease specifics: Document the exact type (coronary heart disease, heart failure with reduced/preserved ejection fraction, NYHA functional class) 2
• Iron deficiency anemia: Include the definition criteria—hemoglobin <12 g/dL (women) or <13 g/dL (men), with iron deficiency defined as ferritin <100 ng/mL or ferritin 100-300 ng/mL with transferrin saturation <20% 2, 1, 3
• Comorbidities: Chronic kidney disease status (eGFR), thyroid function, inflammatory conditions 2, 4

Critical Laboratory Values

• Serial hemoglobin levels: Document trends over the past 6-12 months to show trajectory 1
• Iron parameters: Most recent ferritin, transferrin saturation, serum iron, and total iron binding capacity 2, 1
• Renal function: Creatinine and estimated glomerular filtration rate, as chronic kidney disease significantly impacts anemia management 2, 4
• Inflammatory markers: C-reactive protein if available, as inflammation affects iron absorption 2

Current Treatment Regimen

• Intravenous iron therapy details: If you've received IV iron (ferric carboxymaltose or ferric derisomaltose), document the dosing schedule (typically 200 mg weekly until ferritin >500 ng/mL, then 200 mg monthly for maintenance) and your response 1, 5
• Medications list: Include all cardiovascular medications (ACE inhibitors, beta-blockers, aldosterone antagonists), anticoagulants/antiplatelets, and any oral iron supplements 2, 4
• What NOT to include: Confirm you are NOT on erythropoiesis-stimulating agents (ESAs), as the American College of Physicians strongly recommends against their use in heart disease with anemia due to increased risks of hypertension and thrombosis without mortality benefit 2, 1

Functional Status and Quality of Life Metrics

• NYHA functional class: Document current class and any changes with treatment 2, 1
• Exercise capacity: Include 6-minute walk test results if available, as this is a key outcome measure for iron therapy effectiveness 2, 1
• Symptom burden: Quantify dyspnea, fatigue severity, and any quality of life questionnaire scores (Kansas City Cardiomyopathy Questionnaire if completed) 2, 6

Hospitalization History

• Recent admissions: Document dates and reasons for any heart failure exacerbations or cardiovascular events in the past year 2, 1
• Transfusion history: Note any red blood cell transfusions, as the American College of Physicians recommends restrictive transfusion strategy (hemoglobin threshold 7-8 g/dL) in coronary heart disease 2, 7

Critical Pitfalls to Avoid

Do not allow the summary to become a narrative of every conversation—the cardiovascular center needs actionable data, not a chronological story. 1, 6

Ensure iron deficiency is properly documented using both ferritin AND transferrin saturation, as ferritin <100 µg/L alone does not identify patients more likely to respond to IV iron; transferrin saturation <20% is more predictive, especially in anemic patients. 5

Highlight any gastrointestinal workup results, as chronic blood loss must be excluded before attributing anemia solely to heart failure, particularly if you're on aspirin or anticoagulation. 2, 7

Format Recommendation

Structure the summary as a single-page table or bulleted list with clear sections as outlined above, using bold headers and keeping each entry to one line when possible. Include dates for all laboratory values and treatments. Attach a second page only if needed for detailed medication dosing or hospitalization summaries. 1, 6

The cardiovascular center will specifically need to know your iron status and treatment response, as moderate-quality evidence shows IV iron reduces cardiovascular events in heart failure patients with iron deficiency, and this may guide their ongoing management strategy. 2, 1