Which Is A Cardiac Complication Of An Eating Disorder? Discover The Answer Here

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Eating disorders are serious mental illnesses that have both physical and psychological effects on the body. Anorexia nervosa, bulimia nervosa, and binge-eating disorder are the most common types of eating disorders.

One of the most severe complications associated with eating disorders is their impact on the heart. According to the American Heart Association, an eating disorder can lead to various cardiac complications:

“Anorexia and bulimia can cause an irregular heartbeat called arrhythmia. Arrhythmias can be harmless or life-threatening. In some cases, they may prevent the heart from functioning properly leading to sudden death.”

The damage caused by an eating disorder on the heart depends on various factors such as severity, duration, co-existing conditions, and overall health status. Some of these factors can exacerbate the risk of developing a cardiac complication in individuals struggling with an eating disorder.

In this blog post, we’ll explore which cardiac complication specifically arises from an eating disorder, how it manifests, and what can be done to treat and manage it. By understanding this aspect of eating disorders, we aim to raise awareness around the importance of seeking early intervention and treatment for this condition.


An arrhythmia is a problem with the rate or rhythm of your heartbeat. It occurs when the electrical impulses that coordinate your heartbeats don’t work properly, causing your heart to beat too fast, too slow or irregularly.


Tachycardia is a rapid heartbeat that happens in the heart’s upper or lower chambers and may cause symptoms such as palpitations, shortness of breath, dizziness, chest tightness, or fainting. One of the leading causes of tachycardia can be eating disorders, which affect the health of many young girls.

“Tachycardia is common among people with anorexia nervosa and bulimia nervosa—and it can lead to cardiac complications.” -National Eating Disorders Association (NEDA)

The purging behavior from bulimia leads to electrolyte abnormalities in about half those afflicted with the condition, resulting in some cases with QT prolongation or ventricular arrhythmias that can be fatal. Anorexia has been associated with sinus bradycardia, bundle-branch block, idiopathic left ventricular dysfunction, and sudden death because of ventricular arrhythmia. The body is being put under great stress during these times due to malnutrition and other eating disorder-related consequences, which severely impacts one’s overall well-being.

Atrial Fibrillation

Atrial fibrillation (AFib) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure, and other heart-related complications. Eating disorders also raise the risk of developing AFib due to starvation’s impact on levels of potassium, sodium, magnesium and calcium within the heart muscle cells. Electrolyte levels are necessary in the heart in order to conduct electrical impulses properly and produce a healthy rhythm. However, when an individual is malnourished, levels of these vital electrolytes drop leading to complications including AFib.

“The more underweight someone is, and the longer they remain so, the more likely they will experience changes that lead to this potentially fatal type of heart arrhythmia.” -MedicalNewsToday

Recognizing potential cardiac implications with disordered eating is crucial since early detection can mean tackling damage before it leads to irreversible harm, such as lifelong complications or sudden death. Anyone experiencing symptoms like shortness of breath, racing heartbeat, fainting, chest tightness, confusion, or dizziness must seek help right away for early diagnosis and treatment. Supporting individuals along their journey towards recovery is key towards reducing risk factors associated with eating disorders and preventing significant health issues from developing. Getting on track towards living a healthier life may bring about difficulties at times but sticking to healthy lifestyle habits is imperative in safeguarding one’s physical body and overall wellbeing.

Electrolyte Imbalances

Electrolytes are minerals that carry an electric charge in our body. They play a critical role in regulating nerve and muscle function, balancing blood pH levels, and maintaining fluid balance. Any imbalance in electrolytes can disrupt the normal functioning of the body. Electrolyte imbalances can occur due to several factors such as excessive sweating, vomiting, diarrhea, or an eating disorder.


Hypokalemia is a condition characterized by low potassium levels in the blood. Potassium plays a crucial role in heart and muscle function and its deficiency can lead to cardiac complications. Eating disorders such as bulimia nervosa and anorexia nervosa are common causes of hypokalemia. The frequent purging behavior in bulimia nervosa leads to loss of potassium through vomiting, while inadequate food intake in anorexia nervosa results in decreased potassium absorption. Symptoms of hypokalemia include fatigue, weakness, constipation, irregular heartbeat, muscle cramps, and paralysis. Treatment for severe cases may involve intravenous potassium replacement therapy under close medical supervision.


Hyperkalemia occurs when there is too much potassium in the blood. It can be caused by various factors including kidney disease, medication side effects, or an eating disorder such as binge eating disorder. Binge eating disorder involves recurrent episodes of consuming large amounts of food followed by guilt and shame. During these episodes, large amounts of potassium-rich foods like bananas or potatoes can also be consumed, which can cause hyperkalemia. Hyperkalemia can lead to serious cardiac complications such as arrhythmias and even cardiac arrest. Symptoms of hyperkalemia include palpitations, muscle weakness, numbness, tingling sensation, and difficulty breathing. Treatment may involve careful restriction of potassium intake, medication therapy, and in severe cases, dialysis.


Hyponatremia is a condition that occurs when the level of sodium in the blood is too low. It can be caused by excessive sweating, drinking too much water, or an eating disorder such as compulsive overeating disorder. Compulsive overeating disorder involves recurrent episodes of consuming large amounts of food without control leading to weight gain. During these episodes, some individuals may drink large amounts of water to alleviate feelings of fullness leading to hyponatremia. This electrolyte imbalance can cause serious neurological complications such as seizures, coma, and even death. Symptoms of hyponatremia include headache, nausea, vomiting, confusion, loss of energy, and seizures. Treatment for mild cases usually involves restricting fluid intake while severe cases may require administration of hypertonic saline under close medical supervision.


Hypernatremia is a condition characterized by high levels of sodium in the blood. It can be caused by dehydration, kidney disease, or an eating disorder such as anorexia nervosa. Individuals with anorexia nervosa have an intense fear of gaining weight leading to calorie restriction and dehydration. Dehydration results in increased sodium concentration leading to hypernatremia. Hypernatremia can cause symptoms such as thirst, swollen tongue, restlessness, weakness, and decreased consciousness. In severe cases, it can lead to brain damage and even death. Treatment for hypernatremia involves carefully monitoring fluid intake and correcting dehydration while avoiding rapid correction of sodium levels which can result in cerebral edema.

“Electrolyte imbalances can lead to life-threatening cardiac complications if left untreated. It is important to seek timely medical care if any symptoms of electrolyte imbalances are present.” -Dr. Marcy Stern, MD

Electrolyte imbalances can be life-threatening if left untreated. Timely medical care is essential to avoid serious cardiac complications. Individuals with an eating disorder should seek professional help from psychiatrists and dieticians to address their underlying psychological issues that contribute to the development of the disorder and prevent electrolyte imbalances. A healthy diet that includes a variety of foods rich in electrolytes such as bananas, avocados, spinach, and dairy products can also help maintain optimal levels of electrolytes in the body.


Bradycardia is a condition that occurs when the heart rate drops below 60 beats per minute. It can be caused by many factors, including anorexia nervosa, one of the most common eating disorders that affects millions of people worldwide.

The heart of a person with anorexia has to beat slower because there are fewer nutrients in the body to sustain it. As a result, people with anorexia may develop bradycardia, which can lead to dizziness, fatigue, and even fainting episodes. In severe cases, it can lead to cardiac arrest or death.

If you suspect that you or someone you know has symptoms of bradycardia due to eating disorder, seek medical help immediately. Treatment often involves addressing the underlying cause(s) of the eating disorder to promote healthier habits and improve the overall health of the cardiovascular system.

Sick Sinus Syndrome

Sick sinus syndrome (SSS) refers to a collection of disorders that affect the sinoatrial node( SAN), also known as the heart’s natural pacemaker. The condition manifests through inconsistent electrical signals that regulate heartbeats, leading to rapid movements or pauses between heartbeats.

Research suggests that individuals who experience reoccurring episodes of SSS or a complete atrioventricular block (AVB) have developed this complication due to an eating disorder. Eating disorders can cause nutrient deficiencies, electrolyte imbalances, and hormonal disruptions that interfere with proper SAN function.

Early detection and treatment of Sick Sinus Syndrome are crucial in preventing significant adverse outcomes like sudden cardiac events, stroke, and other chronic complications. Unfortunately, however, SSS is asymptomatic and often not detected sooner until exacerbation of Heart Rhythm Issues.

Atrioventricular Block

An atrioventricular block (AVB) is a condition where electrical impulses from the atria of the heart are delayed or blocked when trying to proceed into the ventricles. This can occur due to several reasons, including electrolyte imbalances and malnutrition caused by eating disorders.

The severity of AVB varies depending on whether it’s a first-degree block, second-degree block, or third-degree block’s level. While first- and second-degree blocks may not cause any symptoms in people with an eating disorder, advanced cases like third-degree regression need instant medical attention as this can lead to other critical cardiac diseases like Bradycardia or Sick Sinus Syndrome mentioned earlier.

“Cardiac complications in patients with anorexia nervosa are relatively common and can be serious, potentially leading to death.” -National Eating Disorder Association

Individuals suffering from eating disorders face various health hazards that disrupt normal physiological functions of their bodies. However, if left unchecked for long, these conditions could lead to severe cardiac complications such as Bradycardia, Sick Sinus Syndrome, and Atrioventricular Block. Therefore, it’s essential to seek medical assistance immediately when experiencing abnormal chest pains, fatigue, difficulty breathing, fainting episodes, or other cardiac-related symptoms. The right diagnosis, treatment plan along with awareness and education about healthy eating habits will go a long way towards providing proper cardiac care for people struggling with eating disorders.

Heart Failure

Heart failure is a condition where the heart fails to pump enough blood and oxygen to meet the body’s needs. It can be caused by various factors such as hypertension, coronary artery disease, diabetes, and obesity.

Left-sided Heart Failure

One of the cardiac complications of an eating disorder that can lead to left-sided heart failure is long-term bulimia or purging. This practice involves inducing vomiting after overeating which causes electrolyte imbalances in the body. A study published in the American Journal of Psychiatry found that bulimia nervosa can lead to low potassium levels which can cause abnormal heart rhythms and ultimately, heart failure.

In addition to bulimia, another common eating disorder known as anorexia nervosa can also cause left-sided heart failure. Anorexia is characterized by self-imposed starvation resulting in significant weight loss and malnutrition. Over time, the lack of nutrients weakens the heart muscle causing it to become less effective at pumping blood throughout the body leading to heart failure.

Right-sided Heart Failure

According to the American College of Cardiology, one of the most common cases of right-sided heart failure secondary to an eating disorder is refeeding syndrome, which occurs when someone with anorexia nervosa begins to eat again after prolonged starvation. When food is reintroduced, insulin production increases rapidly which leads to sharp declines in phosphorus, magnesium, and other important electrolytes. This sudden shift in electrolyte balance can trigger heart arrhythmias and eventually result in heart failure.

Another risk factor for developing right-sided heart failure related to an eating disorder is obesity. People with this condition often have high blood pressure, high cholesterol, and diabetes, all of which are associated with an increased risk of heart disease and ultimately heart failure. According to the National Eating Disorders Association, “obesity and eating disorders can be linked in a complex interplay: low self-esteem, body dissatisfaction, poor coping skills, depression, anxiety, and other mental health issues can contribute to both conditions.”

It is clear that having an eating disorder such as bulimia nervosa or anorexia nervosa significantly increases the risk of developing cardiac complications such as left-sided heart failure secondary to electrolyte imbalances or malnutrition-induced weakening of the heart muscle. Refeeding syndrome as well as obesity-related comorbidities are also factors that can worsen outcomes in individuals with eating disorders. Therefore, early intervention and prompt treatment are essential to preventing long-term consequences on cardiovascular health.

Sudden Cardiac Arrest

Sudden cardiac arrest (SCA) is a sudden and unexpected loss of heart function, breathing, and consciousness. SCA can occur in anyone, regardless of age or gender. In fact, according to the American Heart Association, SCA affects more than 350,000 people each year in the United States alone.

SCA is different from a heart attack, which occurs when blood flow to the heart muscle is blocked. While a heart attack can lead to SCA, not all cases of SCA are caused by a heart attack. Other causes of SCA include:

  • Electrical problems in the heart: Ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT) are two types of electrical problems that can cause SCA.
  • Muscle problems in the heart: These can cause the heart to beat too slowly or erratically, leading to SCA.
  • Trauma to the chest: A severe blow to the chest can disrupt the heart’s normal rhythm and cause SCA.

Ventricular Fibrillation

Ventricular fibrillation (VF) is a type of arrhythmia where the heart’s lower chambers quiver instead of pumping blood effectively. VF can lead to SCA within minutes if not treated promptly. According to the American Heart Association, VF is responsible for about 80% of all SCAs.

The most common causes of VF include:

  • Heart attacks
  • Coronary artery disease
  • Hypertrophic cardiomyopathy
  • Long QT syndrome

If left untreated, VF quickly leads to death. Immediate treatment with defibrillation (a shock to the heart) is essential to convert VF back into a normal heart rhythm.

Pulseless Ventricular Tachycardia

Pulseless ventricular tachycardia (VT) occurs when the heart’s lower chambers beat rapidly and irregularly, leading to a lack of blood flow and oxygen supply throughout the body. VT can also lead to SCA within minutes if not treated promptly.

Some of the causes of VT include:

  • Coronary artery disease
  • Cardiomyopathy
  • Heart attack
  • Electrical shock or trauma to the chest

Treatment for pulseless VT involves immediate defibrillation to restore a normal heart rhythm. If left untreated, pulseless VT can quickly lead to death.


Asystole, also known as “flatlining,” is a total absence of electrical activity in the heart. It is considered one of the most serious arrhythmias because it means that no blood is being pumped through the body. Asystole is typically associated with end-stage heart failure and carries a high mortality rate.

The main cause of asystole is often severe underlying medical conditions such as:

  • Advanced coronary artery disease
  • Hypertrophic cardiomyopathy
  • Myocardial infarction
  • Pulmonary embolism

Immediate treatment for asystole involves basic life support measures including CPR and administration of epinephrine. However, the chances of surviving an episode of asystole are low without advanced cardiac life support interventions.

Pulseless Electrical Activity

Pulseless electrical activity (PEA) is a condition in which the heart appears to be contracting normally on an electrocardiogram (ECG), but there is no pulse or blood pressure associated with each heartbeat. PEA is often called “electromechanical dissociation” because the heart’s electrical and mechanical functions become disconnected from one another.

Some of the causes of PEA include:

  • Hypovolemia (low blood volume)
  • Tension pneumothorax (collapsed lung)
  • Toxic or metabolic disturbances
  • Pulmonary embolism

The first step in treating PEA is to identify and correct any underlying causes such as hypovolemia or tension pneumothorax. Advanced cardiac life support interventions like epinephrine and defibrillation may also be necessary to restore a normal heart rhythm and circulation.

“Sudden cardiac arrest can occur without warning, even in people who seem healthy.” -American Heart Association

Eating disorders such as anorexia nervosa and bulimia nervosa can have serious consequences for cardiovascular health. These conditions cause severe malnutrition and electrolyte imbalances that can lead to arrhythmias, fainting, and even SCA in some cases. Specifically, recent studies have found that people with anorexia nervosa are more likely to experience VF and VT than the general population.

If you or someone you know is struggling with an eating disorder, it is essential to seek professional help right away. Early intervention and treatment can help prevent long-term complications like heart disease and sudden cardiac arrest.

Frequently Asked Questions

What is the relationship between eating disorders and cardiac complications?

Eating disorders can lead to cardiac complications due to malnutrition, electrolyte imbalances, and cardiac muscle damage. These conditions can result in arrhythmias, heart failure, and sudden cardiac death. Eating disorders are a serious risk factor for cardiac complications and require prompt medical attention.

What are some common cardiac complications associated with eating disorders?

Common cardiac complications associated with eating disorders include bradycardia, tachycardia, hypotension, hypertension, electrolyte imbalances, and cardiac muscle damage. These complications can result in arrhythmias, heart failure, and sudden cardiac death. Early diagnosis and treatment are critical to preventing serious cardiac complications.

How does malnutrition contribute to cardiac complications in individuals with eating disorders?

Malnutrition can contribute to cardiac complications in individuals with eating disorders by causing electrolyte imbalances, vitamin and mineral deficiencies, and muscle wasting. These conditions can damage the heart muscle and lead to arrhythmias, heart failure, and sudden cardiac death. Proper nutrition is essential for maintaining heart health in individuals with eating disorders.

What are the warning signs of cardiac complications in individuals with eating disorders?

The warning signs of cardiac complications in individuals with eating disorders include chest pain, shortness of breath, fainting, dizziness, palpitations, and swelling in the legs or ankles. These symptoms require immediate medical attention as they may indicate serious cardiac complications.

What treatment options are available for cardiac complications caused by eating disorders?

Treatment options for cardiac complications caused by eating disorders include medical stabilization, electrolyte replacement, nutritional rehabilitation, and psychotherapy. In severe cases, hospitalization and intensive care may be necessary. Early intervention and treatment are critical to preventing serious cardiac complications and improving overall health outcomes.

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