Anorexia nervosa is an eating disorder with a multisystemic nature, affecting female adolescents predominantly. The disease is potentially fatal with cardiac complications being the leading cause. Left ventricular hypertrophy with obstruction in the ventricular outflow tract, first described in 2006, is a rare but potentially fatal cardiac complication in patients with the disease. We present a clinical case of a 16-year-old girl with anorexia nervosa after a mental trauma, hospitalized in our Clinic in a pre-comatose state with a weight of 26 kg, BSA - 1.12 m2, and BMI - 10.4. On the background of severe abnormalities in homeostasis, bradycardia with left ventricular extrasystoles in bigeminy and episodes of tachycardia with a frequency of 238/min. Echocardiography revealed reduce in the heart size and the left ventricular muscle mass, MI - I+ degree, and a small, apical pericardial effusion. During the follow-up, significant hypertrophy of the left ventricle with obstruction in the outflow tract was registered, without significant change in left ventricular muscle mass. As a result of long-term, comprehensive treatment, with the participation of a team of specialists, the patient achieved true behavioural criticality, improved food tolerance, weight gain up to 46 kg with BMI - 18.4, and normalization of cardiac anatomy, and function. Cardiac complications of anorexia nervosa are common, varied, and potentially lethal and require targeted cardiac monitoring and treatment.

Petar Shivachev completed his PhD at the age of 55 years from Medical University, Varna, Bulgaria. He is a pediatric cardiologist at the St. Marina University Hospital in the city of Varna, Bulgaria. He has over 80 publications that have been cited over 45 times. He has been a reviewer for several reputed journals.