Anorexia Nervosa with Left Atrial Failure

Abstract

A 14-year-old girl with anorexia nervosa was admitted to our hospital because of severe weight loss. She was 152 cm in height and weighed 27 kg. An echocardiogram demonstrated normal left ventricular contraction and a small left ventricular end-diastolic dimension. Pulsed Doppler transmitral flow demonstrated normal early filling velocities but a complete absence of late diastolic flow after the apparent electrocardiographic P wave, consistent with atrial electromechanical dissociation, so called atrial failure. Six months after admission, her body weight increased to 42 kg. Pulsed Doppler showed a normal transmitral flow pattern in both early and late diastole. We do speculate that atrial failure was related to malnutrition due to anorexia nervosa. Atrial failure can be one of the clinical features of patients with anorexia nervosa.