Coronary arterial disease after electroconvulsive therapy: a case report

Objectives Unipolar depression (UPD) is a leading cause of global burden of diseases, particularly among the elderly, whose treatment may be challenging. In such cases, ECT is often recommended due to its safety and efficacy. This report presents a case of a 67-year-old male inpatient that developed a rare cardiac complication during ECT. Methods Clinical case report with patient’s consent and bibliographic review. Results A 67-year-old male inpatient with recurrent severe psychotic depression was hospitalized and ECT was indicated after failure of the pharmacological treatment. A comprehensive clinical pre-evaluation revealed only nonspecific ST-segment changes in electrocardiogram. During the 7th ECT session, it was observed transitory ST-segment depression followed by a discrete increase of plasma troponin I. Severe tri-vessel coronary artery stenosis was found and a percutaneous coronary angioplasty was performed, with satisfactory psychiatric and cardiac outcomes. Conclusions Unipolar depression (UPD) and cardiovascular disease are often coexistent conditions, especially among the elderly. In the current case, myocardial ischemia was detected lately during ECT therapy and its treatment allowed the UPD treatment to be completed adequately.

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Main Authors: Rodrigues,Nataly Pimentel, Santos Júnior,Amilton dos, Andrade,Renato Alves de, Schlittler,Leandro Xavier de Camargo, Sposito,Andrei Carvalho
Format: Digital revista
Language:English
Published: Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro 2015
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0047-20852015000200173
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spelling oai:scielo:S0047-208520150002001732015-07-24Coronary arterial disease after electroconvulsive therapy: a case reportRodrigues,Nataly PimentelSantos Júnior,Amilton dosAndrade,Renato Alves deSchlittler,Leandro Xavier de CamargoSposito,Andrei Carvalho Electroconvulsive therapy major depressive disorder unstable angina coronary stenosis aged Objectives Unipolar depression (UPD) is a leading cause of global burden of diseases, particularly among the elderly, whose treatment may be challenging. In such cases, ECT is often recommended due to its safety and efficacy. This report presents a case of a 67-year-old male inpatient that developed a rare cardiac complication during ECT. Methods Clinical case report with patient’s consent and bibliographic review. Results A 67-year-old male inpatient with recurrent severe psychotic depression was hospitalized and ECT was indicated after failure of the pharmacological treatment. A comprehensive clinical pre-evaluation revealed only nonspecific ST-segment changes in electrocardiogram. During the 7th ECT session, it was observed transitory ST-segment depression followed by a discrete increase of plasma troponin I. Severe tri-vessel coronary artery stenosis was found and a percutaneous coronary angioplasty was performed, with satisfactory psychiatric and cardiac outcomes. Conclusions Unipolar depression (UPD) and cardiovascular disease are often coexistent conditions, especially among the elderly. In the current case, myocardial ischemia was detected lately during ECT therapy and its treatment allowed the UPD treatment to be completed adequately. info:eu-repo/semantics/openAccessInstituto de Psiquiatria da Universidade Federal do Rio de JaneiroJornal Brasileiro de Psiquiatria v.64 n.2 20152015-06-01info:eu-repo/semantics/reporttext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0047-20852015000200173en10.1590/0047-2085000000074
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countrycode BR
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libraryname SciELO
language English
format Digital
author Rodrigues,Nataly Pimentel
Santos Júnior,Amilton dos
Andrade,Renato Alves de
Schlittler,Leandro Xavier de Camargo
Sposito,Andrei Carvalho
spellingShingle Rodrigues,Nataly Pimentel
Santos Júnior,Amilton dos
Andrade,Renato Alves de
Schlittler,Leandro Xavier de Camargo
Sposito,Andrei Carvalho
Coronary arterial disease after electroconvulsive therapy: a case report
author_facet Rodrigues,Nataly Pimentel
Santos Júnior,Amilton dos
Andrade,Renato Alves de
Schlittler,Leandro Xavier de Camargo
Sposito,Andrei Carvalho
author_sort Rodrigues,Nataly Pimentel
title Coronary arterial disease after electroconvulsive therapy: a case report
title_short Coronary arterial disease after electroconvulsive therapy: a case report
title_full Coronary arterial disease after electroconvulsive therapy: a case report
title_fullStr Coronary arterial disease after electroconvulsive therapy: a case report
title_full_unstemmed Coronary arterial disease after electroconvulsive therapy: a case report
title_sort coronary arterial disease after electroconvulsive therapy: a case report
description Objectives Unipolar depression (UPD) is a leading cause of global burden of diseases, particularly among the elderly, whose treatment may be challenging. In such cases, ECT is often recommended due to its safety and efficacy. This report presents a case of a 67-year-old male inpatient that developed a rare cardiac complication during ECT. Methods Clinical case report with patient’s consent and bibliographic review. Results A 67-year-old male inpatient with recurrent severe psychotic depression was hospitalized and ECT was indicated after failure of the pharmacological treatment. A comprehensive clinical pre-evaluation revealed only nonspecific ST-segment changes in electrocardiogram. During the 7th ECT session, it was observed transitory ST-segment depression followed by a discrete increase of plasma troponin I. Severe tri-vessel coronary artery stenosis was found and a percutaneous coronary angioplasty was performed, with satisfactory psychiatric and cardiac outcomes. Conclusions Unipolar depression (UPD) and cardiovascular disease are often coexistent conditions, especially among the elderly. In the current case, myocardial ischemia was detected lately during ECT therapy and its treatment allowed the UPD treatment to be completed adequately.
publisher Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro
publishDate 2015
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0047-20852015000200173
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