Zmiany w układzie sercowo-naczyniowym u pacjentów z jadłowstrętem psychicznym

Abstract

Anorexia nervosa is one of the most common eating disorders, third on the list of the most frequent chronic diseases in young population in a number of developed countries. 85% of anorectic patients are young women, 80% develop cardiovascular complications. The most common symptoms are bradycardia and hypotension. ECG may show repolarization abnormalities, QT interval prolongation and low amplitude of QRS complex. In course of the disease left ventricular size, volume and mass show tendency to reduction, however global systolic function of left ventricle stays unchanged. In some patients impaired diastolic function is observed. The pericardial effusion and mitral valve prolapse are other frequently observed cardiovascular complications of anorexia nervosa. The majority of cardiovascular pathologies connected with the disease does not result in clinically significant symptoms. Specific cardiological treatment is usually not necessary, as the changes resolve spontaneously in course of successful treatment of underlying disease. Cardiovascular complications, especially complex ventricular arrhythmia, are after suicide the second most common cause of sudden death in anorexia nervosa. Among risk factors of sudden cardiac death are listed: significant body weight reduction, long duration of the disease, chronic hypokalemia and hypoalbuminemia and QT interval prolongation in ECG. The symptoms of heart failure are most likely to appear not in the acute stage of anorexia, but during the treatment and while returning to normal body weight. Therefore check-up of cardiovascular parameters is essential in patients with anorexia nervosa – both in the acute stage of the disease and during therapy.