# A Complex Presentation of Anorexia Nervosa and Takotsubo Cardiomyopathy in a Patient of East Asian Descent

## TL;DR

A 52-year-old East Asian woman with anorexia nervosa and takotsubo cardiomyopathy had a unique clinical presentation influenced by her cultural background.

## Contribution

This case highlights the importance of considering cultural factors in diagnosing and managing eating disorders in East Asian patients.

## Key findings

- The patient's perception of her eating disorder and desire to be discharged were influenced by her collectivist cultural mentality.
- Cultural background played a vital role in managing her care and determining her capacity to leave against medical advice.
- No medical abnormalities were found despite her low BMI and eating disorder symptoms.

## Abstract

Anorexia nervosa is an eating disorder characterized by severely low body weight due to psychological reasons. Its presentation and ideal management may differ depending on the cultural background of the patient. We present a 52-year-old female of East Asian descent with a unique presentation of anorexia nervosa and takotsubo cardiomyopathy. An extensive medical workup revealed no medical abnormalities, she reported negative answers to most questions posed in eating disorder screening surveys, and she wished to be discharged against medical advice despite having a BMI of 10 kg/mg2. Her desire to leave as well as her perception of her eating disorder were likely influenced by her collectivist culture mentality, and factoring in her cultural background was vital in managing her care. Patient autonomy vs. beneficence was considered throughout her stay, and she was determined to have the capacity to leave against medical advice two weeks after presenting. This case aims to demonstrate that providers should consider cultural components when caring for patients with eating disorders to better understand causes, treatment preferences, and guide care.