Inducible syncope in anorexia nervosa: two case reports.
OBJECTIVE
Syncope is a potentially dangerous symptom of anorexia nervosa that is usually attributed to bradycardia, dehydration, or hypoglycemia.


METHODS
This study describes two adolescents, one male and one female, with recurrent self-induced syncope associated with isometric exercise.


RESULTS
In one patient, Holter monitoring showed that isometric exercise led to increasing bradycardia followed by asystolic pauses accompanied by presyncopal symptoms.


CONCLUSIONS
We hypothesize that inducible syncope in these two patients is due to increased vagal tone and baroreceptor sensitivity. Physicians should be aware that patients with anorexia nervosa may be able to induce syncope with isometric exercise and that this potentially dangerous behavior needs to be addressed during treatment.
Buchowski
Katherine P
KP
Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland, USA. kpiyaka@jhmi.edu
Pardo
Jennifer
J
Ringel
Richard
R
Guarda
Angela S
AS
D000293:Adolescent; D000856:Anorexia Nervosa / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D011311:Pressoreceptors / Q000502:physiology; D013575:Syncope / Q000453:epidemiology*; D014630:Vagus Nerve / Q000502:physiology