Dr. Lia Ilona Losonczy, MD, MPH

When a patient has sufficient blood volume and lacks one or more components, a complete blood count (CBC) test can help determine if a patient requires a transfusion by measuring four blood components: red blood cells, white blood cells, platelets, and hemoglobin. If any of the patient's component counts is significantly below a standard range, the patient will likely need a blood transfusion. The complete blood count test uses a needle to extract a small amount of blood for testing.

Blood transfusion recipients should be tested for their blood type, which is one of four different types: type A, B, AB, or O. Patients with A, B, and O blood can only receive a blood donation matching their blood type or of O blood, which is known as the universal donor. Those with AB blood are considered "universal recipients"; they may receive A, B, AB, or O blood. Further complicating blood types is the presence or absence of the RhD antigen, adding a positive or negative modifier that should also be considered. Incompatible blood donations may cause transfusion sickness, such as a hemolytic reaction, where the body fights the donated red blood cells.

In certain emergency or trauma situations, medical teams often do not perform a complete blood count (CBC) test or blood type test. In those cases, patients are often given O negative blood, which is universally accepted. Some patients have their blood type on a medical card or bracelet, allowing emergency medical teams to issue compatible blood without testing.

Transfusions are performed by inserting a needle attached to an intravenous line (IV) into a vein in the body. This IV line is attached to a bag of blood that steadily dispenses blood into the patient's bloodstream. The type, volume, and components of donated blood depend on the patient's condition and needs. After the transfusion is complete, patients are generally permitted to resume normal activity, unless prohibited by a condition or injury. Some patients may experience bruising or soreness around the area that the needle was inserted.

At times, a second complete blood count test is performed to determine if the transfusion has brought patients' component counts to normal levels. Some patients may require multiple blood transfusions to reach a healthy blood volume and blood component count.

Once patients' blood volumes and components reach sufficient levels, they will generally begin to feel better. Patients of all ages, from newborn infants to elderly adults, can receive a blood transfusion.

Heart disease is the leading cause of death in the United States for both men and women. This includes coronary artery disease, heart attacks, congestive heart failure, and congenital heart disease. Some conditions, such as genetics, cannot be controlled. But there are many other things one can do to lower their risk for heart disease. Controlling high blood pressure and cholesterol levels, reducing or stopping smoking, exercising more and losing weight if needed, and eating a diet low in sodium can all protect the heart.

Angina is a squeezing type of chest pain that happens when the muscles around the heart don't get enough oxygen. It can be regular or infrequent. Usually, angina is caused by coronary heart disease. However, not all chest pain is angina. Chest pain can also be caused by a lung infection or panic attack, for example, so it is important to have any sudden pain checked.

Arrhythmia is the word for when the heart beats too fast, too slow, or irregularly with skipped beats. It can feel frightening, and depending on the type it can be dangerous, but in most cases arrhythmia is not serious and can be treated. It is very common, especially in older adults.

Heart valve problems can happen in any one of the the heart's four valves that keep blood flowing where it needs to go. Babies can be born with problems in their heart valves, or valves can be damaged by infections. The valves can stiffen and become less mobile, or they can stop closing properly and 'leak' when the heart beats. Valve problems can usually be repaired surgically.

An intra-aortic balloon pump is a small, sausage-shaped balloon at the end of a catheter, or very thin, flexible tube. An incision is made (usually in the groin), and the deflated balloon and catheter are threaded through an artery to the aorta, the large main artery that takes oxygen-filled blood from the heart to the rest of the body. The pump can also be placed during open-heart surgery. If this is the case, it is positioned directly into the aorta. Once in place, the balloon inflates and deflates in rhythm with the heart. When it inflates, it pushes blood back towards the heart to help the heart muscle get enough oxygen and fill correctly. When the IABP deflates, just before the heart contracts, it lowers the pressure in the aorta slightly. This helps move blood away from the heart and into the body.

An IABP is a short-term solution, used for only hours or up to a few weeks at most. The pump is powered and controlled by a computer outside the body, so during treatment patients must remain lying down in their hospital bed. Insertion of the device is performed at a cardiac catheterization lab or operating room, and patients with an intra-aortic balloon pump often stay in the intensive care unit (ICU). While it is not a particularly painful treatment, it is common for patients to hear and feel the balloon inflating and deflating within their chest, which can be unsettling. However, IABP is a safe and effective treatment for supporting the heart.