Cardiovascular complications of anorexia nervosa – a clinical case with transient left ventricular hypertrophy and obstruction in the ventricular outflow tract

Anorexia nervosa is an eating disorder with a multisystemic nature, affecting female adolescents predominantly. The disease is potentially fatal with cardiac complications being the leading cause. We present a clinical case of a 16-year-old girl with anorexia nervosa after a mental trauma, hospitalized in our Clinic in an extremely severe, pre comatose state with weight 26 kg, BSA - 1.12 m2 and BMI - 10.4. On the background of severe abnormalities in homeostasis, bradycardia with left ventricular extrasystoles in bigeminy and episodes of tachycardia with a frequency of 238/min. Echocardiography revealed reduce in the heart size and the left ventricular muscle mass, MI - I + degree and a small, apical pericardial effusion. During the echocardiographic follow-up, there was signiï¬ cant hypertrophy of the left ventricle with obstruction in the outï¬ ow tract, with a reduction in ventricular size, without signiï¬ cant change in left ventricular muscle mass. As a result of long-term, comprehensive treatment, with the participation of a team of specialists, the patient achieved true behavioural criticality, improved food tolerance, weight gain up to 46 kg with BMI - 18.4 and normalization of cardiac anatomy. Cardiac complications of anorexia nervosa are common, varied, and potentially lethal and require targeted cardiac monitoring and treatment. Left ventricular hypertrophy with obstruction in the ventricular outï¬ ow tract, ï¬ rst described in 2006, is a rare but potentially fatal cardiac complication in patients with the disease.