Mitral valve prolapse and anxiety disorders in patients with anorexia nervosa

Much has been written about the occurrence of mitral valve prolapse among eating disordered patients. Despite this literature, a causal relationship between the two conditions has yet to be established. The present study evaluated 500 patients with eating disorders and demonstrated an association between a low median ideal body weight and the frequency of mitral valve prolapse (P less than 0.001). The physical signs and symptoms of mitral valve prolapse disappeared in eating disordered patients with the return of normal weight (P less than 0.001). Contrary to prior reports, there was no association between mitral valve prolapse and the occurrence of diagnosable panic or anxiety disorders. The results of this study suggest that the symptoms of anxiety and panic associated with mitral valve prolapse in eating disordered individuals may be due to physiologic change in cardiac status related to weight rather than central nervous system changes associated with classic anxiety disorders.