title: [Electrocardiographic abnormalities in anorexia nervosa: a critical review of the literature].
abstract: BACKGROUND
  Anorexia nervosa is an eating disorder in which cardiac arrhythmias and sudden death are frequent causes of mortality, which makes electrocardiographic monitoring indispensable in these patients. There are many suggestive findings but results are contradictory, making a critical review of the scientific literature is necessary.
  
  
  METHODS
  The most relevant studies on electrocardiographic (EKG) changes in patients with AN, found in PubMed from 1974 to February 2014, were reviewed using the MeSH terms: eating disorders, nervosa anorexia, sinus bradycardia, QT prolongation, QT dispersion, electrocardiography, EKG, and electrocardiogram.
  
  
  CONCLUSIONS
  The two most common EKG findings reported in the literature are sinus bradycardia and changes in depolarization, as shown by prolongation and increased dispersion of the QT interval. Electrolyte disturbances seem to be the cause of these disturbances in some patients, but other reasons are also discussed in detail, such as QRS right axis deviation, disturbances of heart rate variability, low R wave voltage in V6, amplitude decrease of the QRS and T wave, and QRS prolongation. The majority of authors report that these changes are reversible after treatment of AN.
  
  
  CONCLUSIONS
  These findings support the need for initial and follow-up EKGs in patients with AN and for early diagnosis and treatment of cardiovascular disturbances that are associated with morbidity and mortality. They also support the need for the rational use of psychopharmacology, and that does not increase the risk of arrhythmias and sudden death in these patients.
authors.affiliation: Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Grupo de Investigación en Psiquiatría GIPSI, Fundación Universitaria San Martín, Medellín, Colombia. Electronic address: vargasupegui@gmail.com.
authors.forename: Cristian
authors.initials: C
authors.lastname: Vargas Upegui
authors.affiliation: Grupo de investigación en Psiquiatría GIPSI, Clinical instructor, Department of Psychiatry, University of California , Los Angeles, California, Estados Unidos.
authors.forename: Juliana
authors.initials: J
authors.lastname: Gómez
mesh_terms: D000856:Anorexia Nervosa / Q000150:complications* / Q000503:physiopathology; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D001919:Bradycardia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D004562:Electrocardiography; D006801:Humans; D008133:Long QT Syndrome / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D014883:Water-Electrolyte Imbalance / Q000150:complications
keywords: Anorexia nervosa; Bradicardia sinusal; Dispersión QT; Electrocardiograma; Electrocardiography; Prolongación QT; QT dispersion; QT prolongation; Sinus bradycardia