Long-Term Prognosis in Anorexia Nervosa The cardiovascular implications during refeeding and after weight recovery Mary Carter.

Slides:

Advertisements

Similar presentations

Advance Heart Failure Therapy

Advertisements

Refeeding Syndrome Management Issues Stella Hahn Pulmonary/Critical Care Fellow 2013.

Cardiovascular System

The Athletic Heart.

Malnutrition, Starvation and Refeeding Syndrome Khursheed Jeejeebhoy.

Welcome Applicants!! Morning Report: Friday, November 18 th.

,000 20,00030,000 Rest Normal 50% Lesion 90% 75% Work of the Heart (double product) Coronary Blood Flow.

Early Identification of Obstructive Sleep Apnea and Prevention of Long Term Health Risks Becky Ellis, RN, BSN.

CARDIAC ARRHYTHMIA Charn Sriratanasathavorn, MD,FACC

Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Appendix B Pathophysiology and Clinical Implications.

Electrocardiogram Primer (EKG-ECG)

A.2 Energy in Human Diets. IB Assessment Statement Calculate body mass index between being underweight, normal weight, and obese.

20 Cardiovascular Disease and Physical Activity chapter.

Device-Based Therapy of Cardiac Rhythm Abnormalities

Impaired aerobic capacity/endurance Min H. Huang, PT, PhD, NCS.

CARDIOVASCULAR AUTONOMIC NEUROPATHY IN DIABETICS Michelle Anderton MVS 442 February 4, 1999.

Eating Disorders 1. There are basically two psychological or behavioral eating disorders: Anorexia Nervosa, and Bulimia Nervosa. Obesity is not classified.

Chapter 4 Lesson 5 Managing your weight.

KCNQ1 and Long QT Syndrome

Jenny Morrison Morning Report 4/28/2008.  Cardiomyopathy characterized by transient apical and midventricular LV dysfunction in the absence of significant.

CARDIOVASCULAR SYSTEM E.C.G. Tutorial 1. Calculate Heart Rate. What is Axis ? 2 Normal ECG.

Exercise Management Cardiac Transplant Chapter 13.

Chapter 12 – Miscellaneous Conditions  Artifact  Digitalis Effect  Pericarditis  Early Repolarization  Low Voltage  Hypo- and Hypercalcemia  Hyperkalemia.

Alternating bundle branch block  Alternating bundle branch block is diagnosed when conducted periods of RBBB and LBBB were noted in a patient on the.

Module Nine EATING DISORDERS Lesson 1: Anorexia Nervosa Lesson 2: Bulimia Nervosa.

Day 2 Seminar Types of research articles. Original research article new knowledge for the first time.

Eating Disorders Warm Up: What do you already know about eating disorders?

Victor Carpinteyro Per Bulimia Nervosa  Bulimia is an illness in which people eat large amount of food in a short time. Then they use any.

Module Nine EATING DISORDERS Lesson 1: Anorexia Nervosa (2 training hours) Lesson 2: Bulimia Nervosa (1 training hour) TOTAL TIME: 3 TRAINING HOURS OF.

Exercise Management Chronic Heart Failure Chapter 12.

Slide Number1 Obtaining an ECG Recording the ECG (see Procedure 48-1) Standardization, sensitivity, and speed Mounting an ECG tracing.

PHARMACOLOGIC THERAPY  Standard First-Line Therapies Angiotensin-Converting Enzyme Inhibitors (ACEI) β Blockers Diuretics Digoxin  Second line Therapies.

DR ZIAD NOFAL CARDIOLOGIST DAMASCUS HOSPITAL.  Involvement of peripheral and autonomic nervous systems  Most common complication of diabetes  Underdiagnosed.

Effect of Spironolactone on Diastolic Function and Exercise Capacity in Patients with Heart Failure with preserved Ejection Fraction Effect of Spironolactone.

(Relates to Chapter 36, “Nursing Management: Dysrhythmias,” in the textbook) Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Date of download: 6/2/2016 Copyright © The American College of Cardiology. All rights reserved. From: Long-Term Follow-Up of a Pediatric Cohort With Short.

Recurrent Syncope in Childhood 26/11/15. What is Syncope? Syncope is a temporary loss of consciousness resulting from a reversible disturbance of cerebral.

Anorexia KELLY HENSON EXS 486 WEST CHESTER UNIVERSITY OF PENNSYLVANIA.

Eating Disorders Epidemiology; 4% of adolescent and young adults students Anorexia nervosa has\been reported more frequently over the past several decades.

Emergency Medicine Junior Teaching Programme Aberdeen Royal Infirmary Adult Syncope Evaluation in the Emergency Department Jamie Cooper Teaching 4 th March.

Date of download: 6/25/2016 Copyright © The American College of Cardiology. All rights reserved. From: Sinus node function and ventricular repolarization.

신장내과 R4 강혜란 Cardiorenal syndrome (CRS).  Patients with heart failure (HF) who have a reduced GFR -> Mortality ↑  Patients with chronic kidney disease.

BHS occur most commonly within the first 18 months of age

Heart & Thalassemia . R.Miri,MD, Interventional Cardiologist.

Anorexia Features and Symptoms

Anorexia Features and Symptoms

Eating Disorders Chapter 1.

In certain patients with the long QT syndrome, potassium channel function is reduced (diagonal arrows), which leads to prolongation of the action potential.

Acromegaly is characterized by excessive growth hormone (GH) secretion and is primarily caused by a GH-secreting pituitary adenoma, which stimulates.

Augmented Vector Right Lead: A Game Changer in Acute Coronary Syndrome

Eating Disorders Dr. Vidumini De Silva.

Chapter 17 Eating Disorders

Cardiovascular Dynamics

Syncope in children.

Volume 10, Issue 1, Pages (January 2013)

Sudden Cardiac Death, Mitral Valve Prolapse, and Long QT Syndrome

Mirnela Byku, and Douglas L. Mann BTS 2016;1:95-106

Aortic valve graft implantation in rats: a new functional model

Bar chart of systolic function in healthy individuals, HCM LVH− patients and HCM LVH+ patients. GLS was significantly worse in the HCM LVH+ patients compared.

Andrew D. Krahn, MD, Shubhayan Sanatani, MD, Martin J

Chapter 17 Eating Disorders

Average left ventricular ejection fraction (LVEF) values during the 1 year of observation in patients with preserved systolic function (LVEF >40%) and.

Time to first event analysis revealed a significant difference in estimated event-free (death or hospitalisation) survival between patients with left ventricular.

Distribution of QTc values for patients with and without long QT syndrome (LQTS). Distribution of QTc values for patients with and without long QT syndrome.

The QT interval responses to different pacing rates in a patient in group I. The pacing rate was decreased from 110 to 50 beats/min and the QT interval.

Cardiac Structure and Control

Unadjusted means according to normal versus abnormal cardiac variables among current smokers. DD, diastolic dysfunction; LVM, left ventricular mass; RVFAC,

Presentation transcript:

Long-Term Prognosis in Anorexia Nervosa The cardiovascular implications during refeeding and after weight recovery Mary Carter

Anorexia Nervosa (AN) Is a life-threatening illness which can be accompanied by cardiac symptoms of varying severity. Eighty percent of patients with an eating disorder are effected by a cardiac complication. It has been reported that approximately one third of deaths are due to cardiac complications.

Some cardiac complications Sinus Bradycardia Hypotension Increased Vagal Tone Decreased Voltage and QT Interval Prolongation Diminished Wall Thickness Reduced Cardiac Output

During Refeeding Experimental evidence in animals suggests that decreased compliance and diminished systolic contractility persists. Myofibrillar destruction and edema observed in clinical and experimental starvation offers one explanation for decreased ventricular compliance.

Refeeding Syndrome Accounts for the cardiovascular decompensation seen during therapy. It is a known complication of parenteral hyperalimentation. Hyperalimentation produces striking hypophosphatemia. – Phosphate depletion produces wide-spread abnormalities at the cellular level.

Weight Recovery Patients showed a significant decrease in QT interval (p<.05), and QT dispersion (p<.01) Electrocardiograms showed an increase in cardiac diameters (p<.01), left ventricular mass (p<.001), and cardiac output (p<.001). Exercise capacity improved (0<.05) And there was a normalization of heart rate and heart rate variability (p<.05).

References Mont, Louis, et al, “Reversibility of Cardiac Abnormalities in Adolescents With Anorexia Nervosa After Weight Recovery, Journal of American Academy of Child Psychiatry, 42:7, July, Schochen, Douglas, et al, “Weight Loss and the Heart: Effects of AN and Starvation”, Archives of Internal Medicine, Vol. 149, April 1989.