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[Intrinsic sinus node dysfunction in adolescence during anorexia nervosa]

J M Tarlet1, G Boccara, E Foltzer

  • 1Service de cardiologie, CH Aix-en-Provence.

Archives Des Maladies Du Coeur Et Des Vaisseaux
|April 16, 1998
PubMed
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Anorexia nervosa can cause severe, persistent bradycardia (slow heart rate) and sinus node dysfunction in adolescents, sometimes requiring a pacemaker. This case highlights an unusual presentation resistant to standard treatment.

Area of Science:

  • Cardiology
  • Pediatric Endocrinology
  • Internal Medicine

Background:

  • Anorexia nervosa is associated with cardiovascular complications, including bradycardia, typically responsive to anticholinergic agents.
  • Sinus node dysfunction is rare in young individuals without congenital heart disease.

Observation:

  • A 17-year-old female with anorexia nervosa presented with syncope and severe bradycardia refractory to atropine.
  • Autonomic blockade confirmed intrinsic sinus node dysfunction with chronotropic incompetence.
  • Mobitz I second-degree atrioventricular block was also observed.

Findings:

  • A DDDR pacemaker implantation resulted in an excellent functional outcome.
  • Bradycardia persisted at one-year follow-up despite weight gain.

Related Experiment Videos

  • This case represents an exceptionally severe and treatment-resistant bradycardia in anorexia nervosa.

    • Implications:

    • This case underscores the potential for severe, intrinsic sinus node dysfunction in adolescents with anorexia nervosa.
    • It suggests that bradycardia in anorexia nervosa may, in rare instances, become chronic and require advanced cardiac support.
    • Further research into the pathophysiology of severe cardiac manifestations in anorexia nervosa is warranted.