Tachycardia in anorexia recovery - urgent advice needed

[MaximumVolume]

On behalf of a relative (an adult) who is attempting to recover. She's been out of restriction phase for about a week and her HR is now over 100 at rest from 35-40 when restricting. I'm concerned that she is a risk of sudden heart failure and want her to get checked out today.

She is reluctant.

Any advice on a) whether my concern is justified b) insight on how I might persuade her to go?

[Bloomed]

I would get her checked anyway. We can't predict what an ecg would show and that's a suddem change. No idea how to persuade her. It's a simple process to have an ecg at a and e and heart matters are often given priority.

[MaximumVolume]

I really want to but she's back pedalling. I'm not currently with her. She's just done bp and he. Bp is fine. Hr is 90. When she eats it goes to 120.

[MaximumVolume]

Bump for more visibility.

[Bloomed]

Is her anxiety increasing when she eats?

[Bloomed]

If you tell her how noninvasive and simple the process is would that help? She'll feel better once reassured. No idea how you can get her to go otherwise.

[MaximumVolume]

She says she's not anxious. The anorexia is a relatively new (1 year) addition to other long-term mental health issues. The idea of having to leave the house is stressful for her as well as the idea that they'll say she's wasting their time.

I haven't seen her for ages as she's hiding herself away. Her other issues mean that up until now I've been more useful accepting this and being on the end of the phone/ messenger. Her partner is lovely but works and I suspect he is also now depressed. I spoke to him earlier and he is resigned that she won't go if she doesn't want to.

[MaximumVolume]

Having read a lot about this (she's very aware at times and sends me lots of literature), I'm concerned she's showing signs of serious side effects.

[MaximumVolume]

I'm seriously torn about what to do. If I drive over there I could probably carry her to the car, but I'm thinking that might do more harm than good if she's unwilling and break her trust in me (one of 2 people she currently trusts).

[Flatwhite32]

Hi @MaximumVolume. I'm not anorexic, nor do I have any history of anorexia, but I used to have a condition called SVT, which is a type of tachycardia. Sinus tachycardia (where the heart beats in a normal rhythm, but is just too fast) itself isn't harmful. If the fast heart rate is irregular, it's more serious and may need treating. The problem is, you generally don't know what type of tachycardia it is unless an ECG is done. This is non invasive, but does require the cooperation of the patient. Given the history of anorexia too, I'd be inclined to get your relative checked out. The good thing about ECGs is that they are over very quickly, and will give a good indication as to the type of tachycardia it is. Good luck. X

[KalaLaka]

Call 111?

[MaximumVolume]

Thanks guys. Long chat with her partner. She is seeing the gp later. He has admitted to feeling overwhelmed by it all. He will go with her and is going to consult her in advance about requesting that she is admitted overnight for proper monitoring (so they can see her jumping around hr) and treat her if required.

[jumpingonsomebodyelsestrain]

Pleased to hear your update.

My best friend died from heart failure whist in recovery from anorexia. She ignored the symptoms despite having them for many months before she died.

The risks are very real and I doubt she's in the best psychological place to make informed decisions about her health. Your friend needs her husband and yourself to be her voice whilst she is this unwell.

Thinking of you all.

[Bloomed]

Hope she's OK OP

[MaximumVolume]

Thanks guys. We're in the ambulatory urgent care ward at the hospital, referred by GP so didn't have to go through A&E, thank goodness. She's still protesting that she's waiting everyone's time.

[Bloomed]

Great that she's being seen. Hope all is well.

[Flatwhite32]

Glad she's being seen @MaximumVolume. In my experience, hospitals do take tachycardia seriously, so hopefully she'll get the help she needs.

[MaximumVolume]

She's had a full check and been sent home for tonight. She'll have an in-depth cardiology appointment tomorrow. Thanks for the support and advice.

[MaximumVolume]

@jumpingonsomebodyelsestrain I'm so sorry to hear about your best friend. I was in get-stuff-done mode yesterday and only now realise I was very heartless.

[Noregrets25]

It could be a sign of ‘refeeding syndrome’ she needs to get checked out, be firm!

[kiabella]

Is she restablishing feeding herself or under medical supervision? Usually to avoid refeeding syndrome the refeedibg should be under a dieticians guidance but can be increased quite quickly and there is evidence that it can be started at a slightly higher calorie intake than previously thought.
It is also possible that the big jump could be the body recovering well from restriction as it has been a relatively quick intervention as she has only been ill for a year but it’s always best to get checked. Food is always the medicine hence the weight restoration needing to be the primary focus before therapies or medication are considered

[ErickD]

Hello. I have a similar story. One year Ed. 15 days recovery. Resting hr bump from 45 to 90. Night sweats. Extreme hunger. Gained 7 kilos.
I think this is due to raised metabolic rate. I was eating 2 extremly huge meals a day. Now im cutting this in smaller meals. Hope it will help.
How is your friend doing? And what did the cardiologist say?
Thank you for sharing and best wishes.

[MaximumVolume]

Hi @ErickD the cardiologist was happy with her. Her ECG was fine and he reckoned that the heart is responding to what has become an abnormal stimulus I.e. eating. She's feeling pretty rotten in herself at the moment, but understands she needs to go through this phase. Her assessment at the ED clinic is in a week's time.

[jumpingonsomebodyelsestrain]

Glad to hear she accepting that she needs to go through this period.

I didn't expect an acknowledgement of my experience but thank you. I just felt I had to share because I knew how important it was that she get checked out.

You are a great friend and deserve .

[ErickD]

@MaximumVolume: Thank you for your reply. It calmed me down. Whats more, I talked to other ed sufferers with such a hr bump at beginning of recovery. Eventualy it went down and settled at normal. So, it looks like a natural response.
Yeah, recovery it's hard for me to. A lot of anxiety. But I think of the happy faces of people that truly recovered. Best wishes.

[nyoke]

How many other Ed sufferers experienced the jump in HR in early recovery? How long did it typically take to settle back down to a more normal rate?