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Cardiac abnormalities are one of the complications that these patients can present, and these can be both, structural as well as functional,<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1,2</span></a> therefore, an electrocardiogram (ECG) and echocardiography should be requested during admission. Moreover, the diameter of the inferior vena cava (IVC) and the degree of collapsibility of the same, during inspiration, are used as ultrasound estimators of right atrial pressure and blood volume. In other chronic diseases, such as in haemodialysis patients, an increase of IVC diameter greater than 11.5<span class="elsevierStyleHsp" style=""></span>mm/m<span class="elsevierStyleSup">2</span> is indicative of hypervolemia.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">3,4</span></a> So far, no cases have been reported of isolated dilatation of the IVC in these patients.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We report a series of 3 patients affected by anorexia nervosa, admitted to our unit, which showed dilatation of the IVC in the echocardiography performed during admission, without any other associated cardiac structural abnormality (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). On examination, 3 patients had pitting oedema in lower limbs. At admission, patients had 1 or 2-year history of anorexia nervosa, with a great weight loss in a short period, secondary to intake restriction. All showed a BMI<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>17<span class="elsevierStyleHsp" style=""></span>kg/m<span class="elsevierStyleSup">2</span>, but no other associated cardiac, renal, hepatic, metabolic, hormonal or neurological disease was detected in the extended study. In the ECG, the 3 showed sinus bradycardia, without alterations in repolarization. Blood tests including biochemistry, and general blood count, erythrocyte sedimentation rate, renal and liver function, nutritional profile, coagulation test, cellular and humoral immunity, serology for celiac disease, tumour markers and hormone tests were within normal limits. All had a normal chest radiograph. Abdominal echocardiography showed no underlying reno-urological, gastrointestinal, gynaecological or liver disorders.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Since no organic cause could be found to justify the increase in IVC diameter, it was suspected that patients were taking in plenty of fluids during admission to achieve a greater weight in the daily checks; therefore, water intake was restricted to a maximum of 2<span class="elsevierStyleHsp" style=""></span>l per day. In the subsequent ultrasound control (2 weeks after the restriction) the diameter of the cava was normal in all patients, showed an adequate inspiratory collapse and oedema had disappeared.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Based upon these findings, and without any other apparent cause, the intake of large amounts of fluids to increase the daily weight fictitiously should be ruled out whenever an increase in IVC diameter occurs in patients with anorexia nervosa.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Ayerza Casas A, García Lasheras C, Escartín Madurga L. Dilatación de la vena cava inferior en pacientes con anorexia nerviosa. Med Clin (Barc). 2016;147:569.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">BMI: body mass index; IVC: inferior vena cava.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patient \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age (years) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Weight (kg) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Size (cm) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">BMI (kg/m<span class="elsevierStyleSup">2</span>) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">IVC (mm/m<span class="elsevierStyleSup">2</span>) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">159 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.07 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.03 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">158 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16.42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.92 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">160 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.53 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1338509.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Study of anorexia nervosa patients affected with dilatation of the IVC.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Myocardial changes in a patient with anorexia nervosa: a case report and review of literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "I. 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Journal Information
Vol. 147. Issue 12.
Pages 569 (December 2016)
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Vol. 147. Issue 12.
Pages 569 (December 2016)
Letter to the Editor
Dilatation of inferior vena cava in patients with anorexia nervosa
Dilatación de la vena cava inferior en pacientes con anorexia nerviosa
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