Left Ventricular Hypertrophy and Outflow Tract Obstruction in a Patient With Anorexia Nervosa

Abstract

A 14-year-old girl was admitted to our hospital for hypoglycemia and cardiac tamponade. In the 14 months preceding this hospitalization, she became obsessed with food intake and exercise and developed amenorrhea, disturbed body image, and an intense fear of becoming fat. She subsequently lost 31 kg body weight (decreasing from 52 to 21 kg), meeting the diagnostic criteria for anorexia nervosa. Her rate of weight loss was almost constant for the first 11 months (1.6 kg/mo) but accelerated during the last 3 months before admission (4.7 kg/mo). Chest radiography after drainage of a pericardial effusion (Figure 1A) showed that the patient had an extremely small heart, with a cardiothoracic ratio of …