The 12-lead electrocardiogram in anorexia nervosa: A report of 2 cases followed by a retrospective study

Anorexia nervosa (AN) has been associated with various cardiac disorders an d several electrocardiographic abnormalities, the most prominent being sudd en death and prolonged QT duration and dispersion. We report 2 cases of AN with marked repolarization abnormalities, the first clearly related to elec trolyte imbalance, the second without a good explanation from metabolic, el ectrolytic or pharmacological sources. A retrospective analysis of 47 other consecutive patients with AN showed that sinus bradycardia was the most co mmon ECG finding, but that QT or QTc interval prolongation was not a typica l feature, being present in only 1 patient. The sole variable slightly corr elated with QTc duration was the serum potassium concentration. Consequentl y, marked repolarization changes (QT interval and/or T wave morphology) in AN should not be taken as a feature of the disease, but should call for the search of potential causes such as metabolic and electrolytic disturbances , drug effects, or a possible genetic component.