Pericardial effusion requiring pericardiocentesis in a girl with anorexia nervosa

Objective: Silent pericardial effusion is frequently observed in patients with anorexia nervosa. The nature of the pericardial fluid could never be established, as pericardiocentesis was ethically unfeasible. Method: We describe the case of a girl with anorexia nervosa in whom an initial, clinically irrelevant pericardial effusion increased rapidly, making pericardiocentesis necessary to prevent cardiac tamponade. Results: It was thus possible to exclude the inflammatory or infectious nature of the pericardial fluid, although the pathogenesis of this cardiac alteration remains obscure. Conclusion: Echocardiographic examination appears to be strongly advisable in patients with anorexia nervosa.