The 12-lead electrocardiogram in anorexia nervosa: A report of 2 cases followed by a retrospective study

Abstract

Anorexia nervosa (AN) has been associated with various cardiac disorders and several electrocardiographic abnormalities, the most prominent being sudden death and prolonged QT duration and dispersion. We report 2 cases of AN with marked repolarization abnormalities, the first clearly related to electrolyte imbalance, the second without a good explanation from metabolic, electrolytic or pharmacological sources. A retrospective analysis of 47 other consecutive patients with AN showed that sinus bradycardia was the most common ECG finding, but that QT or QTc interval prolongation was not a typical feature, being present in only 1 patient. The sole variable slightly correlated with QTc duration was the serum potassium concentration. Consequently, marked repolarization changes (QT interval and/or T wave morphology) in AN should not be taken as a feature of the disease, but should call for the search of potential causes such as metabolic and electrolytic disturbances, drug effects, or a possible genetic component.