{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:05:06Z","timestamp":1784307906154,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Severe microcytic anemia may serve as a potentially reversible precipitating factor in heart failure with reduced ejection fraction (HFrEF). This case highlights the diagnostic complexity and hemodynamic consequences of severe, microcytic anemia with undetermined etiology in a patient presenting with newly diagnosed heart failure. A 60\u2010year\u2010old Hispanic woman presented with new\u2010onset acute dyspnea, chest pain, and bilateral edema. Investigations revealed severe microcytic anemia (hemoglobin 4.5\u2009g\/dL, MCV 60.8\u2009fL) and an ejection fraction of 33%. Iron studies (iron 40\u2009\u03bcg\/dL, ferritin 14\u2009ng\/mL, total iron binding capacity 541\u2009\u03bcg\/dL, transferrin saturation 7%) were consistent with presumed iron deficiency anemia. Imaging and fecal occult blood testing did not identify a source of bleeding or malignancy, and endoscopic imaging was not completed due to financial constraints. The patient received packed red blood cells and intravenous iron to stabilize the acute condition. This case highlights the importance of considering severe anemia as a possible precipitating factor in new\u2010onset heart failure, as well as the need for comprehensive evaluation to identify potentially reversible triggers.<\/jats:p>","DOI":"10.1002\/ccr3.72774","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T04:46:08Z","timestamp":1779684368000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["New\u2010Onset Acute Heart Failure With Reduced Ejection Fraction Associated With Severe Microcytic Anemia"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4886-1964","authenticated-orcid":false,"given":"Annabel","family":"Ricci","sequence":"first","affiliation":[{"name":"St. George's University School of Medicine  True Blue Grenada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra","family":"Hunt","sequence":"additional","affiliation":[{"name":"St. George's University School of Medicine  True Blue Grenada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chabelly","family":"Gomez","sequence":"additional","affiliation":[{"name":"Keralty Research Center, Keralty Hospital  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerson","family":"Santafe","sequence":"additional","affiliation":[{"name":"Family Medicine Residency Program, Keralty Hospital  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimee","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Program Director, Family Medicine Residency, Keralty Hospital  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Duarte","sequence":"additional","affiliation":[{"name":"Sanitas USA, Director of Keralty Research Center, Keralty Hospital  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,24]]},"reference":[{"key":"e_1_2_17_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(24)00502\u20106"},{"key":"e_1_2_17_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.emc.2018.04.009"},{"key":"e_1_2_17_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.ndt.a027970"},{"key":"e_1_2_17_5_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.27167"},{"key":"e_1_2_17_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.030099"},{"key":"e_1_2_17_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccas.2020.07.051"},{"key":"e_1_2_17_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.14849"},{"key":"e_1_2_17_9_1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmed.2020\u20100582"},{"key":"e_1_2_17_10_1","unstructured":"The Joint Commission 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