Trastornos de la conducta alimentaria: alteraciones cardiovasculares al ingreso y evolución a 3 meses

Abstract

Female adolescents with eating disordes: cardiac abnormalitiesBackground: Cardiovascular complications can occur in up to 80% of adolescent patients with eating disorders (ED) and account for 30% of their mortality. Aim: To evaluate cardiovascular complications in adolescents with ED and their evolution after refeeding. Patients and Methods: In adolescents with ED admitted to treatment, we assessed the nutritional status, weight loss prior to consultation, presence of bradycardia (BC, defined as heart rate < 60 bpm), we performed an electrocardiogram (ECG) and an echocardiography and measured thyroid hormones. Results: We studied 53 women aged 16.4 ± 2.3 years. Fifteen had a diagnosis of Anorexia Nervosa (AN), seven of Bulimia (BN), eight a not otherwise specified ED (ED-NOS), four a Binge Eating Disorder (BED), sixteen an Atypical Anorexia (AAN) and three an Atypical Bulimia (ABN). Thirty four percent were malnourished and 3.8% overweight. The most common cardiac problem was BC in 51%. In eight of 26 patients in whom an echocardiogram was done, it was abnormal. Six had a decreased ventricular mass, three a pericardial effusion and three valvular involvement. There was a significant association between bradycardia and malnutrition, weight loss and low free triiodothyronine levels. BC was significantly more common in patients with AN, but it also occurred in half of the patients with AAN and in one of three patients with other types of ED. At follow up, bradycardia significantly improved with refeeding. Conclusions: There is an association between all types of ED and bradycardia, as well as anatomical and functional cardiac anomalies.

Malnutrición y Alteraciones Cardiovasculares: Una Revisión Bibliográfica

“…En el artículo de investigación realizado por Marín et al (2019) se realizó un estudio descriptivo de cohorte en 53 mujeres con diagnósticos de TCA en las que la mayoría fueron ingresadas por anorexia nerviosa y anorexia atípica, de las cuales el 34% se encontraron en estado de desnutrición, las edades estudiadas fueron entre los 11 a los 22 años, no presentaron ningún trastorno hidroelectrolítico. En los resultados electrocardiográficos el principal hallazgo fue la bradicardia sinusal sin otras arritmias; al momento del ingreso, el 51% del total de pacientes presentó bradicardia y de estas el 33,3% tuvo bradicardia grave.…”

“…Entre las complicaciones físicas asociadas a los TCA, las arritmias cardíacas son una preocupación importante. Las arritmias cardíacas son alteraciones en el ritmo normal del corazón, lo que puede resultar en latidos demasiado rápidos, demasiado lentos o irregulares (Marín, et al, 2019).…”