Cardiac tamponade in association with anorexia nervosa: A case report and review of the literature

Jacqueline N. Kircher; Matthew H. Park; Michael K. Cheezum; Edward A. Hulten; Jeffrey S. Kunz; Mark Haigney; J. Edwin Atwood

doi:10.5603/CJ.2012.0117

Vol 19, No 6 (2012)

Case Reports

Submitted: 2013-01-24

Published online: 2012-12-06

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Cardiac tamponade in association with anorexia nervosa: A case report and review of the literature

Jacqueline N. Kircher, Matthew H. Park, Michael K. Cheezum, Edward A. Hulten, Jeffrey S. Kunz, Mark Haigney, J. Edwin Atwood

DOI: 10.5603/CJ.2012.0117

Cardiol J 2012;19(6):635-638.

Vol 19, No 6 (2012)

Case Reports

Submitted: 2013-01-24

Published online: 2012-12-06

Abstract

Anorexia nervosa (AN) is a complex psychiatric disorder that can have devastating cardiovascular complications. Its lesser-known association with pericardial effusion has been recently described in the literature. We present the case of a 45 year-old female who presented with a recurrent small bowel obstruction requiring lysis of adhesions and who was found to have a large pericardial effusion that progressed to cardiac tamponade necessitating surgical intervention. The patient had a body mass index of 14.8 kg/m2 (i.e. 71% of ideal body weight) and a long-standing history of food aversion, extreme exercise habits, and weight obsession consistent with AN. To the best of our knowledge, this is the first case of AN-associated cardiac tamponade in the United States, and the first requiring surgical intervention. In conclusion, with this and current data regarding AN-associated pericardial effusions, we recommend a low threshold for performing pre-operative echocardiography for those in whom AN is suspected.