He was free of symptoms or signs of heart failure, or angina, until approximately one month ago. He reports that at that time he began to feel increasingly fatigued. He denies shortness of breath, othopnea, paroxysmal nocturnal dyspnoea, ankle swelling, weight gain, or chest pain. He just feels that he doesn't have the energy he did, and needs to take frequent rests and a nap in the afternoon. Physical examination reveals no sign of heart failure, and no other abnormalities.
Serum ferritin is ordered.
While waiting for it to return, you ask yourself whether serum ferritin is really the best way to determine iron deficiency in such a patient. If so, what that answer is. You are an SHO on a new assignment in the medical out-patient department. Your first patient for the afternoon is a 69 year old white woman, a retired high school teacher, who you are seeing back today to review her test results. A month ago she presented with symptoms and signs of congestive heart failure.