Myocardial Stunning after Electroconvulsive Therapy
Authors: Wei-Xi Zhu, David E. Olson, Barry L. Karon, A. Jamil Tajik
Journal: Annals of Internal Medicine (1992)

Brief Reports1 December 1992Myocardial Stunning after Electroconvulsive TherapyWei-Xi Zhu, MD, David E. Olson, MD, Barry L. Karon, MD, A. Jamil Tajik, MDWei-Xi Zhu, MDSearch for more papers by this author, David E. Olson, MDSearch for more papers by this author, Barry L. Karon, MDSearch for more papers by this author, A. Jamil Tajik, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-117-11-914 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMyocardial stunning (1, 2), a prolonged but reversible myocardial contractile dysfunction, has not been reported after electroconvulsive therapy (ECT). We describe a patient with myocardial stunning after ECT and the apparent prevention of this complication by combined alpha- and beta-blockade.Case ReportA 77-year-old woman was admitted for major depression. She had no history of cardiac disease. Physical examination, routine laboratory tests, and a chest radiograph were negative. An electrocardiogram was normal (Figure 1A). After antidepressant therapy failed, ECT was begun. The patient was premedicated with glycopyrrolate. Anesthesia was induced with thiopental, 100 mg, and succinylcholine, 40 mg. Baseline blood...References1. BraunwaldKloner ER. The stunned myocardium: prolonged, postischemic ventricular dysfunction. Circulation. 1982;66:1146-9. CrossrefMedlineGoogle Scholar2. Bolli R. Mechanism of myocardial "stunning." Circulation. 1990;82: 723-38. CrossrefMedlineGoogle Scholar3. GreenWoods RA. Effects of modified ECT on the electrocardiogram. Br Med J. 1955;1:1503-5. CrossrefMedlineGoogle Scholar4. GouldCopalaswamyChandyKim LCFB. Electroconvulsive therapy-induced ECG changes simulating a myocardial infarction. Arch Intern Med. 1983;143:1786-7. CrossrefMedlineGoogle Scholar5. DecSternWelch GTC. The effects of electroconvulsive therapy on serial electrocardiograms and serum cardiac enzyme values: a prospective study of depressed hospitalized inpatients. JAMA. 1985;253:2525-9. CrossrefMedlineGoogle Scholar6. FineOhEdwardsSandokMeloyMarsh DJWBTR. Electrocardiographic, echocardiographic, and pathological correlation in patients with subarachnoid hemorrhage [Abstract]. J Am Coll Cardiol. 1990;15:215A. CrossrefGoogle Scholar7. Selvin B. Electroconvulsive therapy—1987. Anesthesiology. 1987; 67:367-85. CrossrefMedlineGoogle Scholar8. JonesKnight RP. Cardiovascular and hormonal responses to electroconvulsive therapy. Anaesthesia. 1981;36:795-9. CrossrefMedlineGoogle Scholar9. DecinaMalitzSackeimHolzerYudofsky PSHJS. Cardiac arrest during ECT modified by β-adrenergic blockade. Am J Psychiatry. 1984;141:298-300. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From the Mayo Clinic, Rochester, Minnesota. For current author addresses, see end of text. 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