Introduction: Anorexia Nervosa (AN) is a life-threatening condition, with a significant risk for death, due to cardiac complications.
It is characterized by abnormal eating behavior with the prevalence of 0.5% to 1.0%. It affects predominantly adolescent girls, has the highest mortality rate of all psychiatric disorders, and has been associated with bradycardia, hypotension, mitral valve prolapse and heart failure. The diagnosis of AN can be elusive and more than one half of all cases are undetected.
Purpose: to evaluate cardiac findings in AN.
Patients and Methods: 23 patients (20 females) with AN were examined in the last 3 years, including ECG, echocardiogram and Holter monitoring.
The mean age was 16 years (range 11.5-20), weight loss 13.5 kg (range 6-26), and BMI 15.4 (range 10.9-20). MVP was found in 3, mitral regurgitation (MR) in 4, and mild Aortic stenosis in one. 10 young adults (8 females and 2 males, mean age 15 years), without AN served as a control group.
Results: all patients had bradycardia (mean 44/min, range 26-68/min) documented by ECG and Holter monitoring. Findings were sinus and nodal bradycardia, with no evidence of arrhythmias, or QT interval prolongation. No patient needed pacemaker therapy. In the control group the mean slow heart rate was 74/min (range 66-99/min).
Conclusions: Bradycardia, in young adults, especially females with weight loss, should raise the possible diagnosis of AN, so it can be treated early and promptly in time.