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Bulimia nervosa is an eating disorder characterized by calorie restriction followed by periods of binging. To compensate for the guilt of overindulging, bulimics engage in such unhealthy practices as purging and taking laxative medications. Needless to say, these habits have a profound impact on their health and can adversely affect every organ in their body – even their heart. What types of bulimia heart damage can a person with bulimia nervosa experience?
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Bulimia Heart Damage: Mitral Valve Prolapse
People with bulimia and anorexia nervosa are predisposed to a heart condition called mitral valve prolapse. Mitral valve prolapse is a fairly common heart condition where the mitral valve is “floppy" and doesn’t close properly. Fortunately, mitral valve prolapse rarely causes serious heart problems, and it may be completely asymptomatic. Less commonly, people with mitral valve prolapse have backflow or regurgitation of blood from the ventricle into the atria with each heartbeat. This can lead to heart failure and infections of the heart valve - and surgery may be required to repair the valve.
In one study published in the Archives of Internal Medicine, researchers carried out echocardiograms on 43 people with anorexia nervosa or bulimia nervosa. An echocardiogram is one of the best studies for diagnosing mitral valve prolapse. Among this group with eating disorders, almost 25% had a prolapsed mitral valve - compared to only 4% in the average population. Other studies have also demonstrated a higher incidence of mitral valve prolapse in people with bulimia nervosa and other eating disorders.
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Other Forms of Bulimia Heart Damage
Bulimia heart damage can take other forms. If a person with bulimia nervosa is deficient in protein due to calorie restriction or purging, the heart muscle can atrophy just like other muscles in the body do when a person is malnourished. When this happens the heart can’t pump blood and oxygen effectively, and it can lead to heart failure, irregular heart rhythms and even sudden death.
When people with bulimia nervosa use laxatives or purge, it increases the risk of electrolyte abnormalities, and potassium and magnesium imbalances are most likely. Potassium and magnesium are important for regulating the heart beat, and people with low potassium and magnesium can have irregular rhythms, which can be fatal. Cardiac arrhythmias are the most common cause of death in people with bulimia.
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The Bottom Line?
Bulimia heart damage is a possible complication of bulimia nervosa, and it can manifest in a variety of forms including mitral valve prolapse, heart failure and irregular heart rhythms. Not all bulimics experience heart problems, but for the ones who do, the consequences can be deadly. It’s one more reason why people with bulimia need to be under the care of a doctor who understands the complexities of this mysterious disease.
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Beitr Gerichti Med. 1991;49:343-52.
Emedicine. “Eating Disorder, Bulimia: Differential Diagnoses & Workup."