Having sickled red blood cells lead to the symptoms documented in Anna's medical history when she was 14 months old because as her medical exam noted that her breathing was abnormal and that her respiratory rate is slightly elevated and she seemed short of breath because she had a limited amount of red blood cells, so she was not getting enough oxygen because oxygen is moved throughout the body from red blood cells. Not getting enough oxygen would also explain the reason for her pale skin, nails, and lips. Her heart would also make sense to have a rapid pulse because there was not enough oxygen in the blood stream.
