title: Electrocardiographic and blood pressure alterations during electroconvulsive therapy in young adults.
abstract: OBJECTIVE
  To study cardiovascular alterations in young patients with no apparent organic disease who underwent electroconvulsive therapy.
  
  
  METHODS
  The study comprised 47 healthy patients (22 males and 25 females) with a mean age of 30.3 years, who underwent electroconvulsive therapy. Ambulatory blood pressure monitoring and continuous electrocardiographic monitoring (Holter monitor) were performed during 24 hours. Blood pressure and heart rate were assessed 4 hours prior to electric shock administration, during electric shock administration, and 3 hours after electric shock administration. Arrhythmias and alterations in the ST segment in 24 hours were recorded.
  
  
  RESULTS
  On electroconvulsive therapy, a significant increase in blood pressure and heart rate was observed and the measurements returned to basal values after 25 minutes. Three females had tracings with depression of the ST segment suggesting myocardial ischemia prior to and after electroconvulsive therapy. Coronary angiography was normal. No severe cardiac arrhythmias were diagnosed.
  
  
  CONCLUSIONS
  1) Electroconvulsive therapy is a safe therapeutic modality in psychiatry; 2) it causes a significant increase in blood pressure and heart rate; 3) it may be associated with myocardial ischemia in the absence of coronary obstructive disease; 4) electroconvulsive therapy was not associated with the occurrence of severe cardiac arrhythmias.
authors.affiliation: Instituto de Psiquiatria do Hospital das Clinicas da FMUSP, Sao Paulo, Brazil.
authors.forename: Demetrio Ortega
authors.initials: DO
authors.lastname: Rumi
authors.forename: Maria Cecília
authors.initials: MC
authors.lastname: Solimene
authors.forename: Júlio Yoshio
authors.initials: JY
authors.lastname: Takada
authors.forename: César José
authors.initials: CJ
authors.lastname: Grupi
authors.forename: Dante Marcelo
authors.initials: DM
authors.lastname: Giorgi
authors.forename: Sérgio Paulo
authors.initials: SP
authors.lastname: Rigonatti
authors.forename: Protásio Lemos da
authors.initials: PL
authors.lastname: Luz
authors.forename: José Antonio Franchini
authors.initials: JA
authors.lastname: Ramires
mesh_terms: D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D004565:Electroconvulsive Therapy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000209:etiology / Q000503:physiopathology