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Cussen A, Harding A. Improvement of atrioventricular block with weight restoration in an adolescent with anorexia nervosa. J Paediatr Child Health 2021; 57:2001-2004. [PMID: 33600018 DOI: 10.1111/jpc.15393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/21/2021] [Accepted: 01/29/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Alexandra Cussen
- Department of Paediatrics, Austin Health, Melbourne, Victoria, Australia
| | - Anton Harding
- Department of Paediatrics, Austin Health, Melbourne, Victoria, Australia.,Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.,Women's and Children's Clinical Institute, Epworth Hospital, Melbourne, Victoria, Australia
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2
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Abstract
Anorexia nervosa, one of the more frequent and severe eating disorders, is a chronic psychiatric disease with potentially serious somatic consequences. This behavioral symptomatology leads to weight loss, undernutrition, and more or less severe-potentially life-threatening-somatic complications including respiratory, hepatic, digestive and cardiac features, electrolyte disturbances, endocrine and bone impairment, immunodepression, and related opportunistic infections. In this review, the authors report an overview of cardiac diseases in this disease.
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Affiliation(s)
- Abdallah Fayssoil
- Nutrition Unit, Raymond Poincaré Hospital, APHP, boulevard Raymond Poincaré, 92380, Garches, France. .,Service de neurologie, Institut de Myologie, boulevard de l'hôpital, 75013, Paris, France. .,Pitié Salpetrière Hospital, APHP, boulevard de l'hôpital, 75013, Paris, France.
| | - Jean Claude Melchior
- Nutrition Unit, Raymond Poincaré Hospital, APHP, boulevard Raymond Poincaré, 92380, Garches, France
| | - Mouna Hanachi
- Nutrition Unit, Raymond Poincaré Hospital, APHP, boulevard Raymond Poincaré, 92380, Garches, France
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3
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Poghosyan HR, Danoyan AB, Hovakimyan TB, Kartoyan ZE, Davtyan KV. Cardiogenic anorexia and underweighting in a child: case report. EUROPEAN HEART JOURNAL-CASE REPORTS 2019; 2:yty047. [PMID: 31020127 PMCID: PMC6177046 DOI: 10.1093/ehjcr/yty047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 01/13/2018] [Indexed: 11/29/2022]
Abstract
Introduction In this case, we present a child with a diagnosis of anorexia and no known cardiac disease, who was referred to our clinic for a routine cardiac monitoring. ‘Asymptomatic’ high degree of atrioventricular block (AVB) was revealed. She underwent successful pacemaker (PM) implantation and losing of the weight stopped. Case presentation In this case, the abrupt AVB with more than 6 s ventricular pauses without escape rhythm during the day-time most possible is a type of neurally mediated AVB which was presented by anorexia, underweighting, and refusing to eat in a 12-year-old girl. All symptoms disappeared after PM implantation, and weight gain was recorded during 6 months of follow-up. Discussion The causal link between AVB and anorexia is discussed. In this case, patient’s eating disorder was related to her AV conduction abnormality. The main reason of this case report is to emphasize, that in children with unexplained anorexia and underweighting cardiogenic origin must be excluded.
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Affiliation(s)
- H R Poghosyan
- Department of Cardiac Arrhythmology, Astghik Medical Center, Daniel Varujan 28/1 Yerevan, Armenia
| | - A B Danoyan
- Department of Cardiac Arrhythmology, Astghik Medical Center, Daniel Varujan 28/1 Yerevan, Armenia
| | - T B Hovakimyan
- Department of Cardiac Arrhythmology, Astghik Medical Center, Daniel Varujan 28/1 Yerevan, Armenia
| | - Z E Kartoyan
- Department of Cardiac Arrhythmology, Astghik Medical Center, Daniel Varujan 28/1 Yerevan, Armenia
| | - K V Davtyan
- Department of Cardiac Arrhythmology, Astghik Medical Center, Daniel Varujan 28/1 Yerevan, Armenia.,Heart Rhythm and Conduction Disorder Department, National Medical Research Center for Preventive Medicine, Ministries Healthcare Russian Federation, Petroverigskiy Lane 10, Moscow, Russia
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Vargas Upegui C, Gómez J. Alteraciones electrocardiográficas en anorexia nervosa: revisión crítica de la literatura. ACTA ACUST UNITED AC 2015; 44:33-40. [DOI: 10.1016/j.rcp.2014.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 09/16/2014] [Accepted: 10/17/2014] [Indexed: 10/24/2022]
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Di Cola G, Jacoangeli F, Jacoangeli F, Lombardo M, Iellamo F. Cardiovascular disorders in anorexia nervosa and potential therapeutic targets. Intern Emerg Med 2014; 9:717-21. [PMID: 25056404 DOI: 10.1007/s11739-014-1107-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 07/05/2014] [Indexed: 10/25/2022]
Abstract
Anorexia nervosa (AN) is an eating disorder in which a distorted self-perception of body image and an excessive fear of gaining weight result in extreme restrictions in eating habits. AN may be divided into two types: a "binge-eating/purging type" during which the individual regularly engages in overeating and then purging behavior, and a "restricting type", in which she does not. AN is a serious medical problem in young people in Western societies. It is widely reported that patients with AN exhibit an enhanced mortality rate as compared with age-matched healthy subjects, which has been mainly ascribed to cardiac complications. At least one-third of all deaths in patients with anorexia nervosa are estimated to be due to cardiac causes, mainly sudden death. Cardiovascular complications of AN can be present in up to 80% of cases, and among them alterations in cardiac electrical activity, structure and hemodynamics have been reported as causes of morbidity and mortality. The objective of this brief review is to summarize current knowledge on the main cardiovascular complications of AN, their underlying mechanisms and the possible therapeutic approaches.
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Affiliation(s)
- Giovanni Di Cola
- Dipartimento di Medicina dei Sistemi, Università di Roma Tor Vergata, Via O. Raimondo, 8, 00173, Rome, Italy
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Docx MKF, Loeys B, Simons A, Gewillig M, Proost D, Van Laer L, Mertens L. Intermittent Brugada syndrome in an anorexic adolescent girl. J Cardiol Cases 2014; 10:81-84. [PMID: 30546512 DOI: 10.1016/j.jccase.2014.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 02/23/2014] [Accepted: 03/15/2014] [Indexed: 01/08/2023] Open
Abstract
We report an anorexic adolescent girl with an intermittent Brugada syndrome. A 14-year-old anorexic girl with a body mass index (BMI) of 13.15 kg/m2 was admitted in the acute state of the disease with an ST elevation in V1 and V2, suggestive of Brugada syndrome. After 1 month of re-feeding, a control electrograph (ECG) was normal, but after an 8-month follow-up control with a nearly normal BMI, the ECG was again suggestive of Brugada syndrome. A genetic analysis of the gene SNC5A established a genetic change (p Leu 1582 pro), which provides the final explanation for the Brugada syndrome. Every rhythm problem in the acute state or during the re-feeding procedure deserves a strict follow-up to distinguish iatrogenic from heritable rhythm problems. <Learning objective: (i) We report the first case of a patient with anorexia nervosa with an intermittent Brugada syndrome. (ii) Moderate hypothermia can decrease the depolarization of pacemaker cells and cause ST-segment changes. (iii) Every rhythm problem in the acute state or during the re-feeding procedure deserves a strict follow-up to distinguish iatrogenic from heritable rhythm problems. (iv) A genetic analysis can make the distinction and is necessary to give advice for the future lifestyle of the patient.>.
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Affiliation(s)
- Martine K F Docx
- Department of Paediatrics Queen Paola Children's Hospital, Antwerp, Belgium
| | - Bart Loeys
- Department of Medical Genetics, University Hospital Antwerp, Antwerp, Belgium
| | - Annik Simons
- Department of Child and Adolescent Psychiatry, AZM Middelheim Antwerp and University of Antwerp, Antwerp, Belgium
| | - Marc Gewillig
- Department of Paediatric Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Dorien Proost
- Department of Medical Genetics, University Hospital Antwerp, Antwerp, Belgium
| | - Lut Van Laer
- Department of Medical Genetics, University Hospital Antwerp, Antwerp, Belgium
| | - Luc Mertens
- Division of Cardiology, The Hospital for Sick Children, Toronto, Canada
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Kanbur NO, Goldberg E, Pinhas L, Hamilton RM, Clegg R, Katzman DK. Second-degree atrioventricular block (Mobitz Type I) in an adolescent with anorexia nervosa: intrinsic or acquired conduction abnormality. Int J Eat Disord 2009; 42:575-8. [PMID: 19189406 DOI: 10.1002/eat.20647] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Anorexia nervosa (AN) can cause both functional and structural cardiac complications, including a variety of different conduction abnormalities. This is the first case report of symptomatic diurnal second-degree atrioventricular (AV) block (Mobitz Type I) in an adolescent with AN. We present a 12-year-old girl with AN, restrictor sub-type who reported cardiac symptoms during weight gain, at the time of the initial diagnosis of AV block. Second-degree AV block (Mobitz Type I) is discussed as a possible complication of the AN, as well as being an intrinsic conduction system disease.
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Affiliation(s)
- Nuray O Kanbur
- Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario M5G 1X8, Canada
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Dhoble A, Puttarajappa C, Patel MB, Thakur RK. Heart rate variability in a man with anorexia. Am J Med 2008; 121:e5-6. [PMID: 19028188 DOI: 10.1016/j.amjmed.2008.07.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2008] [Revised: 07/06/2008] [Accepted: 07/10/2008] [Indexed: 11/15/2022]
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Kovalchik S. Comparative study of rate of weight loss among premorbid and healthy restrictive eaters. Eat Weight Disord 2008; 13:176-82. [PMID: 19169073 DOI: 10.1007/bf03327504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Initial body mass index (BMI) and rate of weight loss are compared between cohorts of pathological and healthy dieters. The eating disordered sample consists of young adults reported in case studies in the past ten years with a primary diagnosis of anorexia nervosa (AN). The healthy dieters were adolescents who participated in the National Longitudinal Survey of Adolescent Health and indicated at the time of study enrollment that they were trying to lose weight. At diet initiation, the anorexic sample had a mean BMI (kg/m2) of 20.5 while the healthy dieters had a mean of 24.8. The median rate of weight loss was -1.87 kg per month (1 pound per week) for individuals later diagnosed with AN, while the median weight change was 0.24 kg per month for the Add Health dieters, reflecting an actual gain of 0.13 pounds per week. These findings suggest that measurable physiological characteristics during the early phase of a diet could be predictive of pathological food restriction.
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Affiliation(s)
- S Kovalchik
- University of California Los Angeles - UCLA, Department of Biostatistics, UCLA School of Publich Health, Los Angeles, CA, USA.
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Recovery from lethal arrhythmia after weight gain in a patient with an eating disorder and epilepsy. Pediatr Cardiol 2008; 29:673-5. [PMID: 17999104 DOI: 10.1007/s00246-007-9129-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2007] [Revised: 08/17/2007] [Accepted: 10/16/2007] [Indexed: 10/22/2022]
Abstract
We report a 13-year-old girl with epilepsy who experienced syncope after rapid weight loss due to an eating disorder. She developed a lethal (atrioventricular block) arrhythmia, which improved after weight gain. This case suggests that energy depletion might be involved in lethal arrhythmia.
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