Anorexia nervosa and heart disease: a systematic review

Stefano Giovinazzo, S. G. Sukkar, G. M. Rosa, A. Zappi, G. P. Bezante, M. Balbi, C. Brunelli

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Anorexia nervosa (AN) is an eating disorder that most frequently afflicts females in adolescence. In these subjects, cardiovascular complications are the main cause of morbidity and mortality. Aim of this review is to analyze the hemodynamic, pro-arrhythmic and structural changes occurring during all phases of this illness, including re-feeding. A systematic literature search was performed on studies in the MEDLINE database, from its inception until September 2017, with PUBMED interface focusing on AN and cardiovascular disease. This review demonstrated that the most common cardiac abnormalities in AN are bradycardia and QT interval prolongation, which may occasionally degenerate into ventricular arrhythmias such as Torsades des Pointes or ventricular fibrillation. As these arrhythmias may be the substrate of sudden cardiac death (SCD), they require cardiac monitoring in hospital. In addition, reduced cardiac mass, with smaller volumes and decreased cardiac output, may be found. Furthermore, mitral prolapse and a mild pericardial effusion may occur, the latter due to protein deficiency and low levels of thyroid hormone. In anorectic patients, some cases of hypercholesterolemia may be present; however, conclusive evidence that AN is an atherogenic condition is still lacking, although a few cases of myocardial infarction have been reported. Finally, refeeding syndrome (RFS), which occurs during the first days of refeeding, may engender a critically increased risk of acute, life-threatening cardiac complications.

Original languageEnglish
JournalEating and Weight Disorders
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Anorexia Nervosa
Heart Diseases
Cardiac Arrhythmias
Refeeding Syndrome
Appetite Depressants
Protein Deficiency
Pericardial Effusion
Prolapse
Sudden Cardiac Death
Ventricular Fibrillation
Bradycardia
Hypercholesterolemia
Thyroid Hormones
MEDLINE
Cardiac Output
Cardiovascular Diseases
Hemodynamics
Myocardial Infarction
Databases
Morbidity

Keywords

  • Anorexia nervosa
  • Cardiovascular
  • Complications
  • Heart

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Anorexia nervosa and heart disease : a systematic review. / Giovinazzo, Stefano; Sukkar, S. G.; Rosa, G. M.; Zappi, A.; Bezante, G. P.; Balbi, M.; Brunelli, C.

In: Eating and Weight Disorders, 01.01.2018.

Research output: Contribution to journalArticle

Giovinazzo, Stefano ; Sukkar, S. G. ; Rosa, G. M. ; Zappi, A. ; Bezante, G. P. ; Balbi, M. ; Brunelli, C. / Anorexia nervosa and heart disease : a systematic review. In: Eating and Weight Disorders. 2018.
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