TITULO: TRASTORNOS DE LA CONDUCTA ALIMENTARIA: ALTERACIONES CARDIOVASCULARES AL INGRESO Y EVOLUCIÓN A 3 MESES.

Resumen

Eating Disorders (ED) are psychiatric pathologies with serious physical consequences. Cardiovascular complications can occur in up to 80% of adolescent patients and account for 30% of mortality in this group of patients. OBJECTIVES: To evaluate cardiovascular complications in adolescents with ED, related variables that might explain them, and follow up after 3 months of treatment. PATIENTS AND METHOD: Descriptive study. We evaluated, in adolescents with ED (DSM-5) admitted to treatment, nutritional status, weight loss prior to consultation, bradycardia (BC: heart rate (HR) <60 bpm), ECG, echocardiogram and thyroid hormones. STATISTICAL ANALYSIS: To independent samples we used t-Student, ANOVA, Fisher and Mann Whitney tests. To evolution over time, repeated ANOVA measures and the Q Cochran test were used. RESULTS: 53 women, 16.4 ± 2.3 years, with diagnoses of Anorexia Nervosa (AN:15), Bulimia (BN:7), ED Not otherwise specified (ED-NOS:8), Binge Eating Disorder (BED:4), Atypical Anorexia (AAN:16) and Atypical Bulimia (ABN:3); 34% malnourished and 3.8% overweight. The most frequent complication was BC (51% of all patients). Out of the 26 patients who had an echocardiogram, 8 were altered: 6 with decreased ventricular mass, 3 pericardial effusion and 3 valvular involvement. We observed a significant association between bradycardia and malnutrition, weight loss and low T3L. BC was significantly more frequent in patients with AN, but it also occurs in half of the patients with AAN and in 1 of 3 patients with others ED. At follow up, bradycardia significantly improves with re-feeding (25 at intake, 9 after a month, and 2 after 3 months, p<0.001). DISCUSSION: Our study support the association between restrictive ED and bradycardia, as well as anatomical and functional cardiac anomalies. It reinforces the importance of cardiovascular evaluation in the context of weight loss, regardless of the nutritional diagnosis of the patient.