Nutritional therapy leads to complete recovery of left ventricular dysfunction in anorexia nervosa: A case report

Abstract

This case highlights the cardiac complications associated with anorexia nervosa and how early recognition and treatment significantly affects overall prognosis. A few cases have been reported in literature where cardiomyopathy associated with anorexia nervosa was reported but this is the first case where adequate medical management and metabolic support lead to complete recovery

A young female presented to our hospital with lethargy and dehydration with EKG changes notable for T wave inversions in precordial and inferior leads. Echocardiogram showed severely reduced left ventricular (LV) function. Patient was diagnosed with anorexia nervosa and started on high calorie diet as per metabolic recommendations, ace inhibitor, beta-blockers and statin. 10 month follow up showed a significant improvement in heart function showing the reversible nature of anorexia nervosa induced cardiac dysfunction

Cardiac abnormalities, specifically cardiomyopathy are known in patients with Anorexia nervosa and have been attributed to the deficiency of multitude of minerals, vitamins and electrolytes. It is important to recognize that patients with anorexia can develop cardiac dysfunction and early nutrition along with medical optimization can lead to complete reversal of cardiac dysfunction. Multi-disciplinary team approach involving cardiologist, metabolic support, internist, and psychiatrist is required for appropriate care of these patients.