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Anorexia nervosa with left atrial failure

R Mizuno¹, S Fujimoto, Y Kimura

¹First Department of Internal Medicine, Nara Medical University, Kashihara.

Internal Medicine (Tokyo, Japan)

|December 5, 1998

Summary

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Severe malnutrition in anorexia nervosa can lead to atrial failure, a condition where the atria stop contracting. This cardiac dysfunction resolved with nutritional rehabilitation and weight gain.

Area of Science:

Cardiology
Pediatrics
Gastroenterology

Background:

Anorexia nervosa is a serious eating disorder with significant medical complications.
Cardiac involvement in anorexia nervosa can range from arrhythmias to heart failure.

Observation:

A 14-year-old female with anorexia nervosa presented with severe weight loss (BMI 11.6 kg/m²).
Echocardiography revealed normal left ventricular function but a small end-diastolic dimension.
Doppler studies showed absent late diastolic flow, indicative of atrial electromechanical dissociation (atrial failure).

Findings:

Atrial failure was diagnosed in a patient with anorexia nervosa.
Following nutritional rehabilitation and weight gain (to 42 kg over 6 months), Doppler studies normalized.

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Transmitral flow returned to normal, with restored early and late diastolic filling.

Implications:

Atrial failure may be a reversible clinical feature of severe malnutrition in anorexia nervosa.
This finding highlights the potential for cardiac dysfunction beyond typical cardiovascular manifestations in eating disorders.
Early recognition and nutritional intervention are crucial for managing cardiac complications in anorexia nervosa.