Cardiac arrest: first presentation of anorexia nervosa

Ewan, Sian-Lee; Moynihan, Patricia C.

doi:10.1136/bcr-2013-200876

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…One retrospective study of 153 AN patients with an average BMI at 16.5 for AN-R and 18.8 for AN-BP, selenium deficiency was the most frequent, being observed in half of patients [32]. Moreover, AN-BP patients are exposed to cardiac complications because of associated ionic electrolyte disorders, such as hypokalemia [33] and hypomagnesaemia [34], potentially leading to arrhythmia and sudden death [35]. Our results seem to confirm this cardiac risk that may potentially be increased in AN-BP patients.…”

Section: Discussionmentioning

confidence: 99%

Micronutrients Deficiencies in 374 Severely Malnourished Anorexia Nervosa Inpatients

et al. 2019

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Introduction: Anorexia nervosa (AN) is a complex psychiatric disorder, which can lead to specific somatic complications. Undernutrition is a major diagnostic criteria of AN and it can be associated with several micronutrients deficiencies. Objectives: This study aimed to determinate the prevalence of micronutrients deficiencies and to compare the differences between the two subtypes of AN (restricting type (AN-R) and binge-eating/purging type (AN-BP)). Methods: We report a large retrospective, monocentric study of patients that were hospitalized in a highly specialized AN inpatient unit between January 2011 and August 2017 for severe malnutrition treatment in the context of anorexia nervosa. Results: Three hundred and seventy-four patients were included, at inclusion, with a mean Body Mass Index (BMI) of 12.5 ± 1.7 kg/m2. Zinc had the highest deficiency prevalence 64.3%, followed by vitamin D (54.2%), copper (37.1%), selenium (20.5%), vitamin B1 (15%), vitamin B12 (4.7%), and vitamin B9 (8.9%). Patients with AN-BP type had longer disease duration history, were older, and had a lower left ventricular ejection fraction (LVEF) (p < 0.001, p = 0.029, p = 0.009) when compared with AN-R type patients who, instead, had significantly higher Alanine Aminotransferase (ALT) and Brain Natriuretic Peptide (BNP) levels (p < 0.001, p < 0.021). In the AN-BP subgroup, as compared to AN-R, lower selenium (p < 0.001) and vitamin B12 plasma concentration (p < 0.036) was observed, whereas lower copper plasma concentration was observed in patients with AN-R type (p < 0.022). No significant differences were observed for zinc, vitamin B9, vitamin D, and vitamin B1 concentrations between the two types of AN patients. Conclusion: Severely malnourished AN patients have many micronutrient deficiencies. Micronutrients status must be monitored and supplemented to prevent deficiency related complications and to improve nutritional status. Prospective studies are needed to explore the symptoms and consequences of each deficiency, which can aggravate the prognosis during recovery.

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Section: Discussionmentioning

confidence: 99%

Micronutrients Deficiencies in 374 Severely Malnourished Anorexia Nervosa Inpatients

et al. 2019

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“…In another report, a 33-year-old patient with AN had a cardiac arrest due to left ventricular dysfunction during hospitalization and recovered after immediate ECMO [ 6 ]. In comparison to the cases, the patient in this study had an even longer duration of CPR (Table 1 ) [ 5 - 8 ].…”

Section: Discussionmentioning

confidence: 93%

Neurological Resilience in Patients With Anorexia Nervosa Following Prolonged Cardiopulmonary Resuscitation

Ogiwara,

Wada,

Sai

et al. 2024

Cureus

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Anorexia nervosa (AN) is a psychiatric disorder with metabolic abnormalities. Prolonged cardiopulmonary resuscitation (CPR) is predicted to result in death and poor neurological outcomes. This report describes the case of a patient with AN who had an unexpectedly favorable outcome after prolonged CPR. A 12-year-old female with AN presented to the emergency department, requiring intubation due to worsening consciousness and respiratory distress. Refractory hypotension led to cardiac arrest. After 135 minutes of CPR, venoarterial extracorporeal membrane oxygenation (EMCO) was started, and the patient was treated for post-resuscitation management, refeeding syndrome, and sepsis. The cardiac function gradually improved, the patient was weaned from EMCO eight days after admission, and the patient was extubated 30 days after admission. The patient maintained a good central nervous system function. AN patients tend to be youngsters and have a lower metabolism, which may be associated with a favorable neurological prognosis after prolonged CPR.

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“…Electrolyte disorders known to cause collapse include hypocalcaemia,1 hypercalcaemia,2 hypokalaemia,3 hyperkalaemia,4 hyponatraemia5 and hypernatraemia 6. However, hypophosphataemia is not commonly associated with collapse, although previous reports associate hypophosphataemia with acute confusion,7 visual hallucinations8 and Wernicke’s encephalopathy 9.…”

Section: Introductionmentioning

confidence: 99%

Hypophosphataemia: an important cause of collapse

Williams¹,

Shrikrishnapalasuriyar

Price

et al. 2018

BMJ Case Reports

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We present a case of a 44-year-old man, civil servant, who presented to the emergency department (ED) following an episode of collapse. He was usually fit and well and while at work he had developed a headache with pins and needles over his face and subsequently collapsed. On arrival to ED, he had a Glasgow Coma Scale (GCS) of 4/15. There was no history of note apart from being prescribed citalopram for depression. Laboratory investigations revealed severe hypophosphataemia (phosphate 0.19 mmol/L) and no other electrolyte abnormality. He was commenced on intravenous phosphate and his GCS improved to 15 within 4 hours. Further investigations revealed no cause for his severe hypophosphataemia and repeat bloods in clinic follow-up showed a normal phosphate level.

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Cardiac arrest: first presentation of anorexia nervosa

Cited by 3 publications

References 8 publications

Micronutrients Deficiencies in 374 Severely Malnourished Anorexia Nervosa Inpatients

Micronutrients Deficiencies in 374 Severely Malnourished Anorexia Nervosa Inpatients

Neurological Resilience in Patients With Anorexia Nervosa Following Prolonged Cardiopulmonary Resuscitation

Hypophosphataemia: an important cause of collapse

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