DLC, or Downloadable Content, are essentially extensions to the base, "vanilla" game. They can consist of anything n1g-ga skin packs to complete reworkings of entire countries. The average price for a major DLC range from $10-$20, whilst minor DLC's can range from $10 to Free.
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Several hypotheses have been advanced to explain how iron-deficiency anemia causes cardiomyopathy. It has been suggested that, like other types of heart failure, high-output heart failure is driven by ongoing increased sympathetic nervous activity. In order to test this hypothesis, 1 study used β-blockade in an attempt to blunt the deleterious effect of elevated sympathetic tone on the hearts of iron-deficient laboratory rats. β-Blockers, however, failed to prevent cardiac decompensation in those animals.21
The cardiomyopathy of iron deficiency may be completely reversible. Gradual transfusion of packed red blood cells rapidly reverses clinical heart failure, often within hours.11 Rapid transfusion, in contrast, can precipitate pulmonary edema, as in our patient.9,22 Concomitant administration of a loop diuretic is warranted if congestion is already present or develops, or if rapid transfusion is deemed necessary.
With iron replacement alone, clinical and echocardiographic indices have been shown to normalize.12,18 The mean heart rate decreased from 102 to 93 beats/min after iron-dextran total-dose infusion in 30 patients with iron-deficiency anemia in a study by Alvares and colleagues.12 It is not yet known, however, whether complete normalization of LV function occurs in the more severe cases. Rats fed iron-deficient diets developed dilated cardiomyopathy that was histologically associated with atrophic rather than hypertrophic cardiac myocytes. Myocardial iron concentrates were dramatically reduced. Cardiomyopathy also occurred in iron-deficient rats that were not anemic.23 Similarly, skeletal muscle dysfunction has been found in both children and rats without anemia, when fed short-term iron-deficient diets.23 2ff7e9595c
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