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. 2018 Apr 17;2(2):yty047.
doi: 10.1093/ehjcr/yty047. eCollection 2018 Jun.

Cardiogenic anorexia and underweighting in a child: case report

H R Poghosyan  1 , A B Danoyan  1 , T B Hovakimyan  1 , Z E Kartoyan  1 , K V Davtyan  1   2
Affiliations

Cardiogenic anorexia and underweighting in a child: case report

H R Poghosyan et al. Eur Heart J Case Rep. .

Abstract

Introduction: In this case, we present a child with a diagnosis of anorexia and no known cardiac disease, who was referred to our clinic for a routine cardiac monitoring. 'Asymptomatic' high degree of atrioventricular block (AVB) was revealed. She underwent successful pacemaker (PM) implantation and losing of the weight stopped.

Case presentation: In this case, the abrupt AVB with more than 6 s ventricular pauses without escape rhythm during the day-time most possible is a type of neurally mediated AVB which was presented by anorexia, underweighting, and refusing to eat in a 12-year-old girl. All symptoms disappeared after PM implantation, and weight gain was recorded during 6 months of follow-up.

Discussion: The causal link between AVB and anorexia is discussed. In this case, patient's eating disorder was related to her AV conduction abnormality. The main reason of this case report is to emphasize, that in children with unexplained anorexia and underweighting cardiogenic origin must be excluded.

Keywords: Anorexia; Case report; Child; Paroxismal atrioventricular block; Ventricular pause.

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Figures

Figure 1
Figure 1
Twelve-lead resting electrocardiography revealed sinus rhythm with slight prolongation of PR interval (220 ms).
Figure 2
Figure 2
The strip from the 40-h ambulatory electrocardiography monitoring showed an episode of high degree (7:1) of atrioventricular block with no escape rhythm (ventricular pause is up to 6 s).
Figure 3
Figure 3
The strip from the 24-h ambulatory electrocardiography monitoring after pacemaker implantation showed an episode of ventricular pacing in day-time.
See this image and copyright information in PMC

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