Anorexia nervosa: a cause of pericardial effusion?

Echocardiographic studies revealed the presence of pericardial effusion in 4 patients with anorexia nervosa, whose weights had fallen by 38 to 53% of their body weight at the onset of disease. Each patient had a normal or small cardiac image on chest roentgenogram. The presence of increased pericardial fluid may partially explain the decreased voltage on the electrocardiogram, and the distant heart sounds heard in some of these patients. The cause of the pericardial effusion is not clear. It may possibly occur in other diseases that produce marked weight loss and cachexia.