How should the clinician evaluate and manage the cardiovascular complications of anorexia nervosa?
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.
McCallum
Kim
K
Washington University School of Medicine, and McCallum Place, St. Louis, Missouri, USA.
Bermudez
Ovidio
O
Ohlemeyer
Chris
C
Tyson
Edward
E
Portilla
Maria
M
Ferdman
Barbara
B
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