Document Detail

Exercise Electrocardiography Extinguishes Persistent Junctional Rhythm in a Patient with Severe Anorexia Nervosa.
MedLine Citation:
PMID:  22343463     Owner:  NLM     Status:  Publisher    
Among psychiatric conditions, anorexia nervosa carries the highest mortality, in part due to the propensity for rhythm disturbances among patients with advanced disease. Patients with anorexia nervosa are prone to both bradycardia and tachyarrhythmias, though mortality has not been associated with the former. To date, only one case of junctional rhythm in the setting of anorexia nervosa has been previously described, which was unremitting and required prolonged hospitalization. We report a case of persistent accelerated junctional rhythm where a formal exercise electrocardiography study demonstrated rapid reversion to sinus rhythm with graded exercise. Despite a 22-day hospitalization the patient never reverted permanently to sinus rhythm. This underscores the heightened vagal tone that may be seen among patients with severe anorexia nervosa. Despite this, it may be rapidly extinguished with sympathetic overdrive during exercise. In this context, exercise electrocardiography appears to be a safe, noninvasive means of assessing cardiac conduction and chronotropic reserve in this population.
Mori J Krantz; Jennifer L Gaudiani; Victor W Johnson; Philip S Mehler
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-10
Journal Detail:
Title:  Cardiology     Volume:  120     ISSN:  1421-9751     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  217-220     Citation Subset:  -    
Copyright Information:
Copyright © 2012 S. Karger AG, Basel.
Division of Cardiology, Denver Health Medical Center and University of Colorado, Denver, Colo., USA.
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