This intervention often cures patients of the disorder. The lessons from these reports are two-fold. First, early chelation therapy prevents cardiac dysfunction in patients with transfusional iron overload. Second, congestive cardiomyopathy and arrythmias in these patients are not fixed lesions. Unlike the situation with ischemic cardiomyopathy, the cardiac myocytes have not be destroyed by the pathologic events which produced the dysfunction.
Iron overload injures myocytes by production of free radicals that interfere with their function.
Aggressive intervention with cardiac support and chelation therapy is indicated in patients with iron-mediated cardiac dysfunction. An important question concerning iron and the heart is whether body iron stores in the normal range increase susceptibility to myocardial infarction. A number of small anecdotal reports lie on either side of the issue, and are uninformative. The data indicated that elevated plasma ferritin levels increased the risk of acute myocardial infaction by over two-fold. Plasma ferritin levels are a good serogate of body iron stores.