Takotsubo cardiomyopathy and electroconvulsive treatments: a case study and review.
A 90-year-old woman who had received more than 100 electroconvulsive treatments (ECT) over many years requested another course for depression. After the third ECT, an electrocardiogram showed new T-wave inversion (V2-V6) and ST elevation (V2). Catheterization revealed severe left ventricular dysfunction but no coronary obstruction, leading to a diagnosis of Takotsubo cardiomyopathy (stress-related). The patient's recovery was uneventful. Recent literature cites three other cases post-ECT. It appears that elderly women are at greatest risk, repeated stress is generally required, and recovery is achieved quickly. Elevated levels of catecholamines and of vasopressin may be implicated.
Serby
Michael J
MJ
Beth Israel Medical Center, Department of Psychiatry, Albert Einstein College of Medicine, New York, NY 10003, USA. mserby@chpnet.org
Lantz
Melinda
M
Chabus
Brent I
BI
Bernay
Laura J
LJ
D000369:Aged, 80 and over; D003865:Major Depressive Disorder / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D012008:Recurrence; D054549:Takotsubo Cardiomyopathy / Q000209:etiology*