The Safety of Electroconvulsive Therapy in Patients With Severe Aortic Stenosis

Although there is no specific age cut-off for ECT and no absolute contraindication to its use, very old age as well as the presence of cardiac conditions such as aortic stenosis are factors that may negatively impact the clinician's decision to administer ECT in the individual case. We report our follow-up of a 100 year old female with severe aortic stenosis who has now received ECT safely for a period of 5 years. No cardiac complications have emerged during this period. Her prior unipolar depressive episode with catatonic features remains in remission with a single prophylactic ECT session every 3 months. We have observed from our experience with this unique case that periodic multidisciplinary re-evaluation of the evolving risk-benefit profile of ECT is essential along with the inclusion of family members in this dialogue. Our patient course illustrates that neither advanced age nor severe aortic stenosis are absolute contraindications to ECT even over an extended period of time. Each case needs to be evaluated on its merits. To our knowledge, this case represents the oldest patient in the literature where ECT has been administered safely for such an extended period in the setting of severe aortic stenosis.

Section: Review Of the Literature For Cardiac And Age Related Issues mentioning

confidence: 68%

Section: Review Of the Literature For Cardiac And Age Related Issues mentioning

confidence: 99%

See 1 more Smart Citation

Electroconvulsive Therapy for Treatment of Major Depression in a 100-Year-Old Patient With Severe Aortic Stenosis

O’Reardon¹,

Cristancho²,

Ryley³

et al. 2011

“…Clinical data included details about medications, results of imaging studies, data related to ECT sessions, and evidence of complications related to cardiovascular disease during the periprocedural period, which was defined as the time beginning with the administration of intravenous glycopyrrolate and the induction of anesthesia and ending 24 hours after dismissal from the postanesthesia care unit. 12 Descriptive statistics were used. The Mayo Clinic Institutional Review Board granted permission to undertake this retrospective study.…”

Section: Methodsmentioning

confidence: 99%

Safety of Electroconvulsive Therapy in Patients With Unrepaired Abdominal Aortic Aneurysm

Mueller¹,

Albin²,

Barnes³

et al. 2009

Self Cite

“…12 Concomitant use of antihypertensives and antiarrhythmics may have raised the seizure threshold in our patient who was given metoprolol before the first ECT because of aortic stenosis to prevent severe tachycardia and hypertension. 16,28 In conclusion, patients with an exceptionally high seizure threshold at their first ECT are rare. Until now, besides our patient, very few have been reported in the literature.…”

Section: Discussionmentioning

confidence: 97%

Exceptionally High Initial Seizure Threshold in a Catatonic Patient Treated With Electroconvulsive Therapy

Waarde

Muller²,

Verwey³

et al. 2009