Tarlet J M, Boccara G, Foltzer E, Rahal Y, Pochon P, Jouve B, Barnay C
Service de cardiologie, CH Aix-en-Provence.
Arch Mal Coeur Vaiss. 1997 Nov;90(11):1545-8.
A seventeen year old girl with anorexia nervosa (32 kg; 165 cm) was admitted as an emergency after syncope with severe bradycardia resistant to atropine monitored over a one week period. Autonomic blockade confirmed the intrinsic character of the sinus node dysfunction with chronotropic incompetence on exercise. Secondarily, a Mobitz I second degree AVB was observed. A DDDR pacemaker was implanted with an excellent functional result. With a one year follow-up, the bradycardia persists but body weight has increased. The authors discuss the physiopathology of this case: in the literature, the classical bradycardia of anorexia nervosa is sensitive to vagolytic drugs and only exceptionally as intense as in this patient. Sinus node dysfunction is very rare in the young in the absence of congenital heart disease. It is possible that the bradycardia had become chronic in this case.
一名患有神经性厌食症的17岁女孩（体重32千克，身高165厘米）在出现晕厥并伴有严重心动过缓（对阿托品治疗有抵抗）后被紧急收治，该情况在一周内受到监测。自主神经阻滞证实了窦房结功能障碍的内在特征，运动时心率变时功能不全。其次，观察到莫氏I型二度房室传导阻滞。植入了双腔双感知率应答起搏器，功能效果良好。经过一年的随访，心动过缓仍然存在，但体重有所增加。作者讨论了该病例的生理病理学：在文献中，神经性厌食症的典型心动过缓对迷走神经溶解药物敏感，像该患者这样严重的情况仅为罕见例外。在没有先天性心脏病的年轻人中，窦房结功能障碍非常罕见。在这种情况下，心动过缓有可能已变为慢性。
