Which vital sign pattern would be most concerning in a patient with anorexia nervosa?

Which vital sign pattern would be most concerning in a patient with anorexia nervosa?

• A. Hypertension and tachycardia.
• B. Hypotension and tachycardia.
• C. Hypotension and bradycardia.
• D. Hypertension and bradycardia.

Answer: (C)

In anorexia nervosa, the most concerning vital sign pattern is a slow heart rate with low blood pressure. Malnutrition lowers metabolic demand and increases vagal (parasympathetic) tone, causing bradycardia as the heart rate slows to conserve energy. At the same time, reduced circulating volume and decreased vascular tone lead to hypotension. When these two signs occur together, perfusion to organs can be seriously compromised, raising the risk of fainting, arrhythmias, and heart failure. This combination signals significant cardiovascular compromise and requires urgent assessment and careful monitoring, including attention to electrolyte balance during refeeding. Patterns with fast heart rate or high blood pressure can occur in dehydration or stress, but they do not reflect the same level of cardiovascular risk associated with bradycardia plus hypotension in this context.

In anorexia nervosa, the most concerning vital sign pattern is a slow heart rate with low blood pressure. Malnutrition lowers metabolic demand and increases vagal (parasympathetic) tone, causing bradycardia as the heart rate slows to conserve energy. At the same time, reduced circulating volume and decreased vascular tone lead to hypotension. When these two signs occur together, perfusion to organs can be seriously compromised, raising the risk of fainting, arrhythmias, and heart failure. This combination signals significant cardiovascular compromise and requires urgent assessment and careful monitoring, including attention to electrolyte balance during refeeding. Patterns with fast heart rate or high blood pressure can occur in dehydration or stress, but they do not reflect the same level of cardiovascular risk associated with bradycardia plus hypotension in this context.