In June 1933 there came to our attention a 14 year old girl who presented features suggesting hypopituitarism, possibly due to prolonged undernutrition. One of the striking findings was sinus bradycardia of 34 per minute. From personal inquiry and a survey of the literature it appeared that cardiologists in general are unaware that prolonged undernutrition may produce such marked bradycardia. Further studies on this patient of various cardiovascular features, such as the blood flow and the response to exercise, indicated that the bradycardia was associated with a favorable functional state of the circulatory system.
That marked bradycardia may be the result simply of prolonged undernutrition was first observed by Benedict and his associates,1 who also showed that many of the other features which we observed in our patient, such as a low basal metabolic rate (—37 per cent), low blood pressure (80 systolic and 60 diastolic), a diminished intake
PROGER SH, MAGENDANTZ H. EFFECT OF PROLONGED DIETARY RESTRICTION ON PATIENTS WITH CARDIAC FAILURE. Arch Intern Med (Chic). 1936;58(4):703-727. doi:10.1001/archinte.1936.00170140128008