Cardiac Hemolytic Anemia With Acute Renal Failure: A Case Report Cardiac hemolytic anemia due to a prosthetic valve is a rare cause of acquired hemolytic anemia. Definitive diagnosis is established by the leakage seen on echocardiography and by the numerous schistocytes seen in the peripheral blood smear. Prosthetic valves rarely cause acute tubular necrosis (ATN) via intravascular hemolysis. Surgical correction of the cardiovascular abnormality is the treatment of choice. This is a report of a case with hemolytic anemia presenting with acute renal failure (ARF).