A 39-year-old woman with long-standing anorexia nervosa was admitted t
o our hospital because of extreme weakness and cachexia. During a hype
ralimentation therapy, she developed chest pain, revealing the electro
cardiogram and cardiac enzymes a myocardial infarction of the inferior
wall. We suggest that anorexia nervosa does not 'protect' against cor
onary atherosclerosis, and that some of the cases of sudden death coul
d be related to myocardial ischemia.