Amano K, Sakamoto T, Hada Y, Hasegawa I, Takahashi T, Suzuki J, Takahashi H
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo.
J Cardiogr Suppl. 1986(11):141-7.
Four cases of anorexia nervosa recently encountered were reported in respect to their cardiovascular manifestations including prolapse of the cardiac valves and other poorly recognized cardiac findings. All four patients, aged 13 to 32 years, were women and had marked emaciation (35 to 44% weight loss of the ideal body weight) with typical hormone abnormalities. Chest radiographs showed a small cardiac shadow, and sinus bradycardia with low voltage was present in their electrocardiograms. One case, 13-year-old, had a mid-systolic click and occasionally a late systolic murmur, and also an abdominal continuous hum. Echocardiography including two-dimensional color flow-mapping disclosed mitral valve prolapse in all, and tricuspid valve prolapse in two. Mild to moderate pericardial effusion was noted in all between the right ventricle and diaphragm, and pericardiocentesis in one case had no effect on the valve movements. No inflammatory changes were observed in the specimen of the pericardium and also of the fluid. An association of mitral valve prolapse and anerexia nervosa was discussed based on the previous studies, but the final conclusion remains unknown.
报告了最近遇到的4例神经性厌食症患者的心血管表现，包括心脏瓣膜脱垂及其他鲜为人知的心脏检查结果。所有4例患者年龄在13至32岁之间，均为女性，有明显消瘦（体重减轻至理想体重的35%至44%）及典型的激素异常。胸部X线片显示心脏阴影较小，心电图显示窦性心动过缓伴低电压。1例13岁患者有收缩中期喀喇音，偶尔有收缩晚期杂音，还有腹部连续性杂音。包括二维彩色血流图在内的超声心动图显示，所有患者均有二尖瓣脱垂，2例有三尖瓣脱垂。所有患者右心室与膈肌之间均有轻度至中度心包积液，1例心包穿刺对瓣膜活动无影响。心包及心包液标本未观察到炎症改变。基于先前的研究对二尖瓣脱垂与神经性厌食症的关联进行了讨论，但最终结论仍不明确。
