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Case Reports
. 2022 Sep 5;10(9):e6286.
doi: 10.1002/ccr3.6286. eCollection 2022 Sep.

Electroconvulsive therapy in a patient with hypertrophic cardiomyopathy: A case report

Marco Kufner  1 , Caroline Nothdurfter  1 , Dagmar Steffling  1 , Andrea Baessler  2 , Lars S Maier  2 , Yasmin Qamar  2
Affiliations
Case Reports

Electroconvulsive therapy in a patient with hypertrophic cardiomyopathy: A case report

Marco Kufner et al. Clin Case Rep. .

Abstract

The use of electroconvulsive therapy (ECT) in patients with underlying cardiac disease like hypertrophic cardiomyopathy (HCM) remains without satisfactory clinical guidelines. We provide a case report of successful application of ECT in a 43-year-old patient with bipolar disorder and comorbid HCM, including detailed diagnostic information and outlining key clinical considerations.

Keywords: bipolar disorder; case report; electroconvulsive therapy; hypertrophic cardiomyopathy; major depressive disorder.

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Figures

FIGURE 1
FIGURE 1
Electrocardiography. Negative T‐waves and a positive Sokolov–Lyon Score indicate left ventricular hypertrophy
FIGURE 2
FIGURE 2
Magnetic resonance imaging, SSFP sequences. (A) diastole; (B) systole. RA denotes right atrium, RV right ventricle, LA left atrium, LV left ventricle and VS ventricular septum, indicating a concentric hypertrophic cardiomyopathy mostly stressed in the apex and medial third of the left ventricle
FIGURE 3
FIGURE 3
Echocardiography examples. (A) parasternal long axis; (B) parasternal short axis; (C) apical view. Left ventricle (asterisk), ventricular septum (arrow) with left ventricular hypertrophy
FIGURE 4
FIGURE 4
Clinical time course during ECT. The area resembles the subjective ratings of the patient on a visual analogue scale (VAS) between “very bad” to “very good.” Red triangles indicate the ECT dates. A rise in scores during ECT therapy with an immediate setback after ECT discontinuation (after 2.5 months) is observable. At the end of the observation time (end of blue area), subjective VAS ratings reflected a good clinical state after a second setback at time of hospital discharge (after 3 months).
FIGURE 5
FIGURE 5
ECG monitoring during ECT. A sinus arrest of 8 s followed by a sinustachycardia of approximately 130 beats per minute is observable
See this image and copyright information in PMC

References

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