Cardiological Aspects of Feeding and Eating Disorders in Children and Adolescents and Associations with Refeeding Syndrome, Purging Behaviors, and Psychoactive Drugs

Feeding and Eating Disorders (FEDs) constitute a complex spectrum of psychiatric conditions, impacting physical and psychosocial well-being. This retrospective observational study aimed to dissect the electrocardiographic (ECG) alterations in pediatric patients with FEDs, correlating them with clinical factors, treatment modalities, Refeeding Syndrome (RS) and the reversibility of ECG abnormalities post-treatment. Analyzing records from a third level Italian Regional Center for FEDs in children and adolescents, the study encompassed 150 patients meeting the inclusion criteria. Sinus bradycardia was the prevalent ECG alteration, notably in Anorexia Nervosa (AN) restrictive type. Association analyses revealed links between the severity of AN, hormonal imbalances, and amenorrhea and ECG abnormalities. Pharmacological interventions, particularly antipsychotics, exhibited associations with a QT interval prolongation. RS demonstrated significant correlations with potassium and magnesium imbalances, which were linked to specific ECG changes. This study highlighted the reversibility of ECG abnormalities, concomitant with Body Mass Index improvement. This analysis underscores the critical cardiac implications of FEDs, advocating for multidisciplinary interventions and close cardiac monitoring. Early detection and holistic care are imperative in managing patients with FEDs in the developmental age, offering potential reversibility of cardiac alterations post-treatment. These findings underscore the need for prospective studies to validate these observations and delve deeper into cardiac involvement in FEDs.