Congestive heart failure as cause of death in an anorexia nervosa fatal case

Anorexia nervosa (AN) is a psychiatric disease predominantly affecting adolescent girls and young adult women characterized by severe eating disorders that lead to chronic protein–energy malnutrition and high lifetime mortality. An excess mortality from cardiovascular diseases for AN patients has been reported [1]; patients with AN show a predisposition to sudden death with no apparent anatomical cause. Most of the cardiovascular associated mortality and morbidity in AN, is likely to stem from arrhythmia: QT prolongation, first degree-heart block, ectopic atrial foci, premature ventricular complexes, bradycardia, and other arrhythmias are seen. Other cardiac findings in AN include hypotension, mitral valve prolapse, and decreased cardiac mass. Finally, heart failure has been reported.