Cardiogenic shock managed with phlebotomy: an unusual case of end-stage cardiac hemochromatosis

Iron-overload syndromes are often asymptomatic early in the disease with evidence of rapid deterioration once there is clinical evidence of heart failure. Therapeutic phlebotomy is the treatment of choice in non-anemic patients before severe complications including cardiomyopathy develops. Our clinical case highlights a significant improvement in hemodynamics after initiation of phlebotomy. Phlebotomy is beneficial because it depletes body iron stores and oxidative stress and enhances vascular function.