Myocardial hypoxia due to anemia can manifest as which condition?

• A. Myocardial infarction
• B. Heart failure
• C. Angina pectoris
• D. Palpitations

Answer: (C)

Anemia lowers the oxygen-carrying capacity of blood, so myocardial oxygen delivery can fall below the heart’s needs, especially during exertion or stress. To compensate, the heart increases rate and contractility, raising oxygen demand; when supply cannot meet this demand, the heart becomes ischemic and produces angina pectoris—chest discomfort from reversible myocardial ischemia. This is the classic manifestation of hypoxia-induced ischemia due to anemia.

Myocardial infarction involves acute coronary artery occlusion with necrosis, not just supply-demand mismatch from anemia. Palpitations can accompany anemia but are nonspecific, and heart failure is more about chronic volume/pressure overload and reduced pumping efficiency rather than isolated ischemic chest pain.