Bradycardia: an important physical finding in anorexia nervosa

Cardiovascular complications are common in patients with anorexia nervosa, an eating disorder resulting in severe malnutrition that affects multiple organ systems. Sinus bradycardia is the most common cardiovascular physical finding and the most common arrhythmia in patients with anorexia nervosa. It is important to appreciate the significance of sinus bradycardia in this clinical setting because it may be associated with sudden death, especially in the presence of other arrhythmias or EKG abnormalities, such as prolongation of the QTc interval. Since sinus bradycardia can occur in up to 95% of patients with anorexia nervosa, its clinical correlation with more lethal arrhythmias cannot be overemphasized. Physicians must be aware of the common cardiac findings on the physical examination of a patient with anorexia nervosa in order to refer those patients to tertiary care centers for treatment by eating disorder specialists.