What should be included in a comprehensive summary sheet for a patient with iron deficiency anemia and cardiovascular disease, including comorbid conditions such as chronic kidney disease (CKD), current medications like intravenous (IV) iron therapy, Angiotensin-Converting Enzyme (ACE) inhibitors, beta-blockers, anticoagulants, and antiplatelets, and recent laboratory values like hemoglobin, ferritin, transferrin saturation, and renal function tests?

Comprehensive Summary Sheet for Cardiovascular Center Visit

Patient Demographics & Diagnosis

• Name: [Your Name]
• Date of Birth: [DOB]
• Date: [Today's Date]
• Primary Diagnoses: Iron Deficiency Anemia, Cardiovascular Disease, Chronic Kidney Disease

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Current Comorbid Conditions

• Chronic Kidney Disease (CKD): Stage ___ (eGFR: ___ mL/min/1.73m²) 1
• Cardiovascular Disease: [Specify: Heart Failure NYHA Class ___, Coronary Artery Disease, etc.] 1
• Iron Deficiency Anemia: [Absolute / Functional] 2, 3
• Other conditions: [Diabetes, Hypertension, etc.]

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Current Medications

Iron Therapy

• IV Iron: [Specify: Iron sucrose / Ferric carboxymaltose / Ferric gluconate / Ferumoxytol] 1, 4, 5
  • Dose: ___ mg
  • Frequency: ___ (e.g., weekly, every 2 weeks)
  • Start date: ___
  • Total doses received: ___

Cardiovascular Medications

• ACE Inhibitor/ARB: [Name] ___ mg [frequency] 1
• Beta-Blocker: [Name] ___ mg [frequency] 1
• Anticoagulant: [Name] ___ mg [frequency] 1
• Antiplatelet: [Name] ___ mg [frequency] 1
• Diuretic: [Name] ___ mg [frequency] 1
• Statin: [Name] ___ mg [frequency]

Anemia Management

• Erythropoiesis-Stimulating Agent (ESA): [Yes/No] 1, 4
  • If yes: [Name] ___ units [frequency]
  • Start date: ___

Other Medications

• [List all other medications with doses and frequencies]

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Recent Laboratory Values

Hematology (Date: ___)

• Hemoglobin: ___ g/dL (Normal: M >13, F >12) 1, 2
• Hematocrit: ___ %
• Mean Corpuscular Volume (MCV): ___ fL
• Reticulocyte Count: ___ /mm³ 1
• White Blood Cell Count: ___ /mm³
• Platelet Count: ___ /mm³

Iron Studies (Date: ___)

• Serum Ferritin: ___ ng/mL 1, 4
  • Target for CKD non-dialysis: >100 ng/mL
  • Target for hemodialysis: >200 ng/mL
• Transferrin Saturation (TSAT): ___ % 1, 4
  • Target: >20% (optimal >27%)
• Serum Iron: ___ mcg/dL
• Total Iron Binding Capacity (TIBC): ___ mcg/dL

Renal Function (Date: ___)

• Serum Creatinine: ___ mg/dL 1
• Estimated GFR (eGFR): ___ mL/min/1.73m² 1
• Blood Urea Nitrogen (BUN): ___ mg/dL

Cardiac Biomarkers (Date: ___)

• NT-proBNP or BNP: ___ pg/mL 1
• Troponin: ___ ng/mL

Inflammatory Markers (Date: ___)

• C-Reactive Protein (CRP): ___ mg/dL 1, 4

Other Labs (Date: ___)

• Vitamin B12: ___ pg/mL 1
• Folate: ___ ng/mL 1
• Thyroid Function (TSH): ___ mIU/L 1
• Albumin: ___ g/dL

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Functional Status & Symptoms

NYHA Functional Class (for Heart Failure)

• Current Class: I / II / III / IV 1

Anemia-Related Symptoms 2

• Fatigue: Yes / No (Severity: Mild / Moderate / Severe)
• Dyspnea on exertion: Yes / No
• Exercise intolerance: Yes / No
• Lightheadedness: Yes / No
• Restless legs syndrome: Yes / No
• Pica: Yes / No
• Difficulty concentrating: Yes / No
• Depression/irritability: Yes / No

Six-Minute Walk Test (if available)

• Distance: ___ meters (Date: ___) 1

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Iron Deficiency Classification 4, 3

Based on current labs:

• Absolute Iron Deficiency: TSAT ≤20% AND Ferritin <100 ng/mL (non-dialysis) or <200 ng/mL (hemodialysis)
• Functional Iron Deficiency: TSAT ≤20% AND Ferritin >100 ng/mL (non-dialysis) or >200 ng/mL (hemodialysis)
• Iron Replete: TSAT >20% AND adequate ferritin

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Treatment Response & Trends

Hemoglobin Trend

• Baseline (Date: ___): ___ g/dL
• Most recent (Date: ___): ___ g/dL
• Change: ___ g/dL 1, 5

Iron Parameters Trend

• Ferritin: Baseline ___ → Current ___ ng/mL 5
• TSAT: Baseline ___ → Current ___ % 5

ESA Dose Changes (if applicable)

• Initial dose: ___ units
• Current dose: ___ units
• Response: Adequate / Inadequate 1, 4

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Relevant Clinical History

Bleeding History

• Gastrointestinal bleeding: Yes / No (Date: ___) 2
• Menstrual bleeding (if applicable): Heavy / Normal 2
• Other bleeding sources: ___

Malabsorption Issues 2, 6

• Celiac disease: Yes / No
• Inflammatory bowel disease: Yes / No
• Prior bariatric surgery: Yes / No (Type: ___, Date: ___)
• Atrophic gastritis: Yes / No

Oral Iron Tolerance

• Previous oral iron trial: Yes / No 1
• If yes: Tolerated / Not tolerated (Side effects: ___)

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Allergies & Adverse Reactions

• Drug Allergies: [List all]
• Previous IV iron reactions: Yes / No 1, 5
  • If yes: [Describe reaction and formulation]

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Questions for Cardiovascular Team

1. Optimal hemoglobin target given my cardiac condition? 1
2. Safety of current IV iron regimen with my ferritin/TSAT levels? 4, 7
3. Need for ESA therapy adjustment? 1, 4
4. Cardiovascular risk assessment with current anemia management? 1, 8
5. Frequency of monitoring recommended? 1

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Prepared by: [Your Name]
Contact: [Phone Number]
Primary Care Physician: [Name, Phone]
Nephrologist: [Name, Phone]
Cardiologist: [Name, Phone]