Complete recovery from severe myocardial dysfunction in a patient with anorexia nervosa.
This report describes a patient who experienced cardiopulmonary arrest caused by severe hypoglycemia and malnutrition, which was successfully treated with percutaneous cardiopulmonary support (PCPS) and intra-aortic balloon pumping (IABP). A 33-year-old female with anorexia nervosa (AN) was transferred to the emergency center because of a loss of consciousness. On admission, she was extremely emaciated, hypotensive, and hypoglycemic (10 mg/dl). A chest X-ray showed butterfly shadow. Echocardiography showed severe hypokinesis of left ventricular wall motion. On the 3rd hospital day, she experienced cardiac arrest. Myocardial dysfunction caused by malnutrition was suspected, and therefore both PCPS and IABP were administered for circulatory support and myocardial protection. Thereafter, cardiac function gradually recovered and she was later weaned from PCPS and IABP on the 9th and the 10th hospital day, respectively. She was discharged from the intensive care unit on the 43rd hospital day with normal cardiac function. Her neurological outcome after 6 months as evaluated by the Glasgow Outcome Scale was considered to be good recovery. Cardiomyopathy in AN patients is reversible ventricular dysfunction, and circulation assisting devices are considered for the treatment of cardiogenic shock.
Ono
Takeru
T
Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, Japan.
Kasaoka
Shunji
S
Fujita
Motoki
M
Yamashita
Susumu
S
Kumagai
Kazumi
K
Kaneda
Kotaro
K
Tsuruta
Ryosuke
R
Maekawa
Tsuyoshi
T
D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications*; D009202:Cardiomyopathies / Q000209:etiology* / Q000628:therapy*; D002315:Cardiopulmonary Bypass; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy; D006801:Humans; D007003:Hypoglycemia / Q000150:complications; D007423:Intra-Aortic Balloon Pumping; D044342:Malnutrition / Q000150:complications; D012720:Severity of Illness Index; D012770:Shock, Cardiogenic / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome