I’ve written in brief about heart problems with anorexia, but it’s any eating disorder that can also produce severe heart problems. This is the hidden killer for many. I found that not knowing Sophie’s true heart rate until she was in hospital to be a very critical issue. The GP and others treating her before her first hospital admission, didn’t mention heart problems either. Nor did they do a full check on heart rate – lying down, sitting, standing. There was never a moment that they measured drop rate. They also never mentioned the heart rate overnight, when it normally drops. For those with anorexia this is very very critical. Many have their heart rate drop into emergency intensive care zones during this time and never know it. It happened to us and thousands of others. The scary side – heart failure – and not even knowing that it was getting the heart was getting that low.
As we coasted towards our second hospital admission, this time I was more than aware. Our specialist doctor did the proper heart rate tests, but I pushed our GP to do the same (and still struggled for them to understand how important this was). I also took Sophie’s heart rate late at night and in the early morning before she got up. It gave me a very real idea of what her heart was dropping to overnight, it gave me more mileage with the GP and getting her pushed onto the critical admission list.
The article below also outlines the different types of heart problems that arise with eating disorders. I didn’t know that last two and frankly, we should all be told these things regardless when we are in treatment care. I’ve put just the heart information here, but the full article that covers more general information about anorexia is available: http://www.everydayhealth.com/columns/jared-bunch-rhythm-of-life/for-both-men-and-women-anorexia-nervosa-is-increasing-and-the-effects-on-the-heart-can-be-severe/
Anorexia and the Heart
Here are four broad patterns in which the heart is affected with both short- and long-term exposure to anorexia nervosa:
1. Loss of heart muscle. Just like the skeletal muscles in your arms and legs that you can see, the heart muscle loses mass. In patients with longstanding anorexia the heart walls thin and weaken. The heart chambers then enlarge. The pumping function of the heart declines and with it, blood pressure falls. Organs that are very sensitive to blood pressure and blood flow such as the kidneys and liver then begin to fail. Fortunately with weight gain and replenishment of essential vitamins and minerals the heart muscle often recovers.
2. Abnormal heart rhythms. A number of abnormal heart rhythms can occur with anorexia. One is that the heart beats slowly, a pattern called bradycardia. This is a particular problem in people who have weak heart muscles. Normally if the heart function weakens and less blood is pumped with each beat, the heart has to increase the number of beats per minute to maintain the same average blood flow. With anorexia, if the energy stores in the heart are so depleted that the heart rhythm cannot increase to compensate for a weakened heart failure, blood pressure falls more quickly and organ failure develops rapidly.
Another concern is fast abnormal heart rhythms. People tend to be most sensitive to these types of rhythms if they follow a pattern of binge eating and purging. This can result in dangerous shifts and loss of body electrolytes such as sodium, potassium, and magnesium. The electrical aspects of the heart that create heartbeats are critically dependent on these electrolytes. When they fall, chaotic electrical patterns can develop in the lower heart chambers that result in cardiac arrest.
3. Loss of the autonomic regulation of the heart and blood vessels. Our bodies do a lot of things that we are unaware of to help us function. For example, the simple act of sitting or standing requires multiple complex changes in the body. Among these are constricting of the blood vessels to raise blood pressure, and a subtle elevation of the heart rate and contractility of the heart. In people with anorexia these reflexes can be impaired or lost. This can result in profound drops in blood pressure when attempting to sit, stand, or walk. People with anorexia can experience severe lightheadedness, fainting spells, and even cognitive changes.
4. Mitral valve prolapse. The heart valve between the upper and lower chambers on the left side of the heart is called the mitral valve. It closes when the lower heart chamber contracts to pump blood throughout the body. The changes in the heart muscle mass compared the structure of the heart valve can affect the closing of the valve. The mitral valve then can close less tightly and prolapse into the upper heart chamber. In people with anorexia about 20 percent will have mitral valve prolapse. Unfortunately, the heart valve condition appears to persist even after weight gain.
I am seeing more patients with anorexia in my clinic. To a physician, low body weight and in particular the pattern of muscle loss are noticeable signs. Most of my patients with anorexia eat a low to low-normal calorie content in a day, but then exercise excessively. Despite being very underweight they still discuss weight loss goals they hope to attain. More recently, I have encountered a surge in misuse of “natural” therapies to cleanse or purge the colon or work as a diuretic. These therapies are every bit as dangerous when misused as prescription laxatives and diuretics, and can lead to severe mineral and electrolyte depletion a
