In the later years of the nineteenth century, several writers on chlorosis described the occurrence of cardiac murmurs and enlargement of the heart and the postmortem observation of myocardial dilatation, hypertrophy and degeneration.1 Since that time similar changes have been noted with many varieties of anemia, especially with the more chronic forms, such as the pernicious, the sickle cell and the erythroblastic type. Other symptoms and signs have been described, and the pathology of the cardiovascular system has been more carefully studied.2
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Anemia may produce signs which suggest primary heart disease. The murmurs are not necessarily of the so-called hemic type, in which the bruit is systolic in time and is confined to the base of the heart, but they may be heard in both systole and diastole and may be either generalized or localized to any of the valvular areas.3 In