The Cardiovascular Complications of Eating Disorders
The Cardiovascular Problems of Eating Disorders
The physical dangers of eating disorders are not always understood by the person suffering from one - or their friends and family. This may be because not every person with an eating disorder is severely underweight or looks obviously malnourished. Still, the lack of calories and appropriate nutrition takes its toll on the organs of the body, including the heart. What are the cardiovascular complications of eating disorders?
The Cardiovascular Complications of Eating Disorders: Decreased Heart Rate
One of the most common signs seen in people with eating disorders who are malnourished and underweight is a decrease in heart rate, a condition known as bradycardia.
Bradycardia, a heart rate of less than sixty beats per minute, isn’t always a bad sign. Some athletes who train hard routinely have heart rates of less than sixty. To complicate matters, some people with eating disorders also exercise compulsively. Because of this an unusually slow heart rate in someone with an eating disorder may be interpreted as a sign of being ‘physically fit”.
In reality, the heart, along with the rest of the body, is slowing down to compensate for inadequate calorie intake. This may be one of the first signs of serious problems in a people suffering from an eating disorder, although the bradycardia itself rarely causes problems.
Cardiovascular Problems of Eating Disorders: Mitral Valve Prolapse
People with anorexia nervosa or bulimia have a higher risk of a condition called mitral valve prolapse. This is where the mitral valve that separates the left atrium from the left ventricle doesn’t close properly. The inadequate closure of the valve allows blood to seep back into the atrium when the heart contracts. According to one study, 37% of people with anorexia or bulimia have this condition. This can put them at higher risk for irregular heart rhythms, fatigue, dizziness, shortness of breath, or chest pain.
Dangerous Irregular Heart Rhythms
People with eating disorders, particularly bulimia, may experience deficiencies in electrolytes, particularly potassium, from vomiting or taking laxatives. This can lead to abnormal heart rhythms, which may be fatal.
Surprisingly, one of the times a person with an eating disorder may be most prone to a fatal heart rhythm is when they start to eat again. Eating high-carbohydrate foods in a malnourished state causes fluctuations in insulin levels leading to rapid potassium and phosphate shifts into cells, including cardiac cells, which can lead to heart failure or sudden death. This is called refeeding syndrome - which is why a person with an eating disorder needs to be monitored closely during treatment. This is one of the most serious cardiovascular complications of eating disorders.
Other Cardiovascular Complications of Eating Disorders
People who are malnourished from an eating disorder may lose musculature in their heart muscle as the body breaks down muscle throughout the body to use the protein for energy. This reduces the work capacity of the heart and increases the risk of sudden death. The combination of all of these different heart complications can occur in the same person, which significantly increases the risk of death.
Cardiovascular Problems of Eating Disorders: The Bottom Line?
The cardiovascular complications of eating disorders can be life-threatening. In fact, heart-related problems are the most common cause of death in people with anorexia nervosa. This makes treatment and close monitoring all the more important.
Arch Intern Med. 1986 Aug;146(8):1525-9.
Br Heart J. 1994 March; 71(3): 287–292.
West J Med. 2000 March; 172(3): 189–193.