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Extreme bradycardia as presentation of an eating disorder
  1. Elizabeth Anderson1 and
  2. Julian Gunn2,3
  1. 1Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, South Yorkshire, UK
  2. 2Cardiovascular Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  3. 3Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK
  1. Correspondence to Dr Julian Gunn; j.gunn{at}


We present a case of extreme bradycardia in an 18-year-old man, accompanied by bilateral pleural effusions, pericardial effusion, endocrine dysregulation and Horner’s syndrome. Despite extensive investigations as an inpatient and multidisciplinary input, it was not until subsequent assessment by an endocrine team that it was revealed that his presentation was attributable to an eating disorder. Following dietary advice, easing of extreme exercise and continued support, the patient improved in all parameters including body mass index and he remains well. This case demonstrates the importance of a thorough personal history incorporating all aspects of social and dietary history.

  • cardiovascular medicine
  • arrhythmias
  • nutrition and metabolism
  • eating disorders

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  • Contributors JG contributed to the diagnosis and management of the case, design and conceptualisation of the case report and review of the manuscript. EA contributed to design and conceptualisation of the case report, drafting and revision of manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.