Anemia may be difficult to identify at first because the initial symptoms tend to be mild. Also, if the anemia develops gradually, the body will adjust to the decreased level of oxygen, possibly masking some of the symptoms. However, over time, as the anemia worsens, symptoms may emerge, including:

• Fatigue
• Weakness
• Shortness of breath
• Confusion
• Dizziness
• Pale skin
• Feeling cold, especially in the hands or feet

These symptoms result from the lack of oxygen-rich blood to the brain and other areas of the body. In some cases, patients may also show heart-related signs or symptoms of anemia, such as:

• Abnormal heart rhythm (arrhythmia), such as an abnormally fast heartbeat (tachycardia ) or a pounding, galloping heartbeat (palpitations)
  
  
• Heart murmur
  
  
• Chest pain