title: How should the clinician evaluate and manage the cardiovascular complications of anorexia nervosa?
abstract: Five to twenty percent of patients with anorexia nervosa die from their illness. One half of those patients die of medical complications (Steinhavsen, 2002). Malnutrition, dehydration, and electrolyte abnormalities may precipitate death by inducing heart failure or fatal arrhythmias. Patients and their families commonly call upon physicians to evaluate acute and ongoing risks of malnutrition and purging behaviors. Concerns about medical compromise currently tend to determine or influence insurance coverage of medical and psychiatric treatment of patients with eating disorders. There is very limited published data to guide clinicians in the evaluation, ongoing monitoring, or treatment. Surprisingly, no consensus exists regarding recommendations for either the ongoing evaluation of cardiac parameters or the clinical implications of common findings.
authors.affiliation: Washington University School of Medicine, and McCallum Place, St. Louis, Missouri, USA.
authors.forename: Kim
authors.initials: K
authors.lastname: McCallum
authors.forename: Ovidio
authors.initials: O
authors.lastname: Bermudez
authors.forename: Chris
authors.initials: C
authors.lastname: Ohlemeyer
authors.forename: Edward
authors.initials: E
authors.lastname: Tyson
authors.forename: Maria
authors.initials: M
authors.lastname: Portilla
authors.forename: Barbara
authors.initials: B
authors.lastname: Ferdman
mesh_terms: D000856:Anorexia Nervosa / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D001291:Attitude of Health Personnel; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D003681:Dehydration / Q000453:epidemiology / Q000209:etiology; D004452:Echocardiography; D004562:Electrocardiography; D006304:Health Status; D006801:Humans; D007022:Hypotension / Q000453:epidemiology / Q000209:etiology