title: Myocardial changes in a patient with anorexia nervosa: a case report and review of literature.
abstract: OBJECTIVE
  Anorexia nervosa (AN) is an eating disorder with high mortality and morbidity. Much of the mortality is related to cardiovascular complications manifesting with electrocardiogram abnormalities and morphologic abnormalities documented on ultrasound. However, gross and histologic abnormalities in the heart have been rarely described in association with this eating disorder.
  
  
  METHODS
  We present an autopsy case of an adult patient with AN. We describe the clinical presentation of this patient, as well as significant gross and histologic abnormalities of the heart, and discuss their implications.
  
  
  RESULTS
  At autopsy, the heart was small with mainly a small left ventricle. Histologically, we found endocardial and interstitial fibrosis, areas of myxoid material deposition with mast cells in the background, and increased cytoplasmic lipofuscin.
  
  
  CONCLUSIONS
  The gross findings in the heart correlate with the previously described anomalies on cardiac ultrasound of patients with AN. The fibrosis and myxoid material deposition might be a direct consequence of starvation and the mechanism of death in some patients with AN.
authors: From the Department of Pathology, Rush University Medical Center, Chicago, IL, and.
authors: Ihab
authors: I
authors: Lamzabi
authors: From the Department of Pathology, Rush University Medical Center, Chicago, IL, and.
authors: Sahr
authors: S
authors: Syed
authors: From the Department of Pathology, Rush University Medical Center, Chicago, IL, and.
authors: Vijaya B
authors: VB
authors: Reddy
authors: From the Department of Pathology, Rush University Medical Center, Chicago, IL, and.
authors: Richa
authors: R
authors: Jain
authors: From the Department of Pathology, Rush University Medical Center, Chicago, IL, and.
authors: Aparna
authors: A
authors: Harbhajanka
authors: Cook County Medical Examiner Office, Chicago, IL.
authors: Ponni
authors: P
authors: Arunkumar
mesh_terms: D000856:Anorexia Nervosa / Q000473:pathology*; D001344:Autopsy; D002318:Cardiovascular Diseases / Q000473:pathology*; D004562:Electrocardiography; D017809:Fatal Outcome; D005260:Female; D005355:Fibrosis / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*
keywords: Anorexia nervosa; Autopsy; Heart; Myocardium