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Int J Angiol 2013; 22(02): 083-094
DOI: 10.1055/s-0033-1334138
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Significance of Bradycardia in Anorexia Nervosa

Malka Yahalom
1   HaEmek Medical Center, Heart Institute, Afula, Israel
,
Marcelo Spitz
2   Department of Children and Psychiatry, Western Galilee Hospital, Nahariya, Israel
,
Ludmila Sandler
2   Department of Children and Psychiatry, Western Galilee Hospital, Nahariya, Israel
,
Nawaf Heno
3   Department of Pediatrics, Western Galilee Hospital, Nahariya, Israel
,
Nathan Roguin
4   Rappaport School of Medicine, Technion, Haifa, Israel
,
Yoav Turgeman
1   HaEmek Medical Center, Heart Institute, Afula, Israel
4   Rappaport School of Medicine, Technion, Haifa, Israel
› Author Affiliations
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Publication History

Publication Date:
10 May 2013 (online)

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Abstract

Anorexia nervosa (AN) is a life-threatening condition, with a significant risk for death, due to cardiovascular complications. It is characterized by abnormal eating behavior and has the highest mortality rate of all psychiatric disorders. It has been associated with bradycardia (a heart rate [HR] of less than 60 beats per minute) (up to 95%), hypotension, mitral valve prolapse, and heart failure. The diagnosis of AN can be elusive, and more than half of all cases are undetected. The purpose of this study was to raise and improve awareness to the possible diagnosis of AN in adolescent and young adult patients with weight loss displaying bradycardia and new cardiac disorders. Clinical characteristics, HR, and electrocardiographic data of 23 consecutive patients (20 females) with AN and of 10 young adults (8 females) without AN, between the years 2006 and 2009, were recorded and summarized. At presentation 16/23 (69.6%) showed HR < 50 bpm. The mean lowest HR of all patients was 44 ± 6 (range 26 to 68) bpm. No patient needed pacemaker therapy. Bradycardia in young adults, especially females with weight loss, should raise the possible diagnosis of AN, so it can be treated early in-time, and thus prevent premature death.

Keywords

anorexia nervosa - bradycardia - sudden death
 

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