Need Doctor Who Understand’s Anorexia’s Effect on the Heart

By December 10, 2012

I was diagnosed with anorexia when I was 17. I’m 22 now. I recovered visibly a couple years ago, and weigh 120 lb. at 5’4″ but I still don’t eat as much as I should. I take in about 600-700 calories on a good day, and few of those calories are from carbs. I also exercise a lot, from 40 to 100 minutes each day. I know I’m still very much messed up in my mind, but it’s hard to go back to therapy because it’s expensive and my parents don’t like it. For the past few years I’ve been having strong and abnormal heartbeats, which apparently have been palpitations and possibly arrhythmia this whole time. I thought everyone had it (I’m not a biology expert), and that everyone could feel their heart beating at anytime, till I was reading the newspaper one day about a boy who died from “palpitations” which were described as what I have. I was shocked, and after speaking to my brother about it who’s a biology person, he said what I have is not normal. What I have exactly is, I can feel my heart beating very strongly, to the point where I can feel its beat in my head. Sometimes it’s around 55 bpm, but if I have a good-sized meal (which for me means about 1/2 of a normal person’s meal) it’ll start beating crazily, up to 80 bpm. If I just have a full piece of toast instead of 1/2 piece, it’ll react that way, my heart reacts strangely towards too much food, which I know in reality that this food is not too much at all. What do I do? I know I need to see a doctor, but the irregularities in my heart are sporadic. I got it checked out twice, but the doctor said its fine, and it was fine, but only at that moment was it fine. Sometimes it’s ok, sometimes it goes crazy. I feel these doctors don’t understand the implications of having an eating disorder and its effect on the heart. The effect being sometimes the signs show and sometimes they don’t. So who do I go to? Because I know something’s wrong with my heart. I live in south Florida, is there anyone down here you’d recommend? I’m afraid one day I’ll just drop dead because my heart will give up. – anonymous

Dear Anonymous,

Your heart symptoms do need to be evaluated more thoroughly. Anxiety can cause such symptoms; however, more serious medical issues need to be ruled out.

You need an event monitor, which will monitor your heart over the period of days to weeks. You wear this around and it records every heartbeat, and records when your heart has an abnormal rhythm. You also may need an echocardiogram which is an ultrasound of the heart.

Ask to be referred to a cardiologist, and then tell the cardiologist about your eating disorder. Unless they know what they are looking for, they won’t be able to help you.

I also encourage you to get back with a therapist. You need to deal with your eating disorder thoughts and food restriction. Talk with your parents honestly about your struggle. They would want to know.

I wish you the best!

Brenda K. Woods, MD, FAAFP