Prolonged and fluctuating giant T-wave inversion after electroconvulsive therapy.
A 76-year-old woman was scheduled to receive 8 treatments of electroconvulsive therapy (ECT) for severe depression. Although she experienced no adverse consequences in the first 2 treatments, giant T-wave inversion ensued from the third treatment despite no change in anesthesia or technical parameters of ECT. T-wave inversion appeared to have almost disappeared 8 days after the third ECT, but reappeared at 3 weeks after treatment during severe pain from gallbladder stone. T-wave inversion lasted for 4 months with gradual attenuation. Exaggerated sympathetic stimulation associated with ECT as physical and emotional stressors might have played a role in the appearance of T-wave inversion similar to catecholamine-induced cardiomyopathy. Furthermore, reappearance of T-wave inversion may have been involved in additive effects of pain from gallbladder stone on vulnerability due to a catecholamine-induced cardiomyopathy-like condition.
Ito
Masanobu
M
Department of Psychiatry, Juntendo University School of Medicine, Tokyo, Japan. masa110@med.juntendo.ac.jp
Hatta
Kotaro
K
Miyakawa
Koichi
K
Miyauchi
Katsumi
K
Arai
Heii
H
D000368:Aged; D003865:Major Depressive Disorder / Q000628:therapy; D004562:Electrocardiography; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D005260:Female; D042882:Gallstones / Q000150:complications / Q000503:physiopathology; D006331:Heart Diseases / Q000209:etiology* / Q000503:physiopathology*; D006801:Humans; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D013564:Sympathetic Nervous System / Q000503:physiopathology; D013997:Time Factors