Long term effects of Bulimia. Permanent damage?

When the body doesn't have the proper amount of food containing all your nutrients it goes after your muscle which of course that would mean the heart. You need to go have a good workup and do it as soon as possible. Make sure you are very honest with you doctor about your problems and have him help you with your smoking. I wish you the best of luck but I would suggest you get to a doctor a lot sooner then the end of the month.