TY - JOUR
T1 - Electroconvulsive therapy in a 96-year-old patient with severe aortic stenosis
T2 - A case report and review of the literature
AU - O'Reardon, John P.
AU - Cristancho, Mario A.
AU - Cristancho, Pilar
AU - Fontecha, Jeisson F.
AU - Weiss, David
PY - 2008/3
Y1 - 2008/3
N2 - We report the safe administration of a course of electroconvulsive therapy (ECT) in a 96-year-old woman with severe aortic stenosis. The patient experienced a relapse of her severe depression when ECT had been withheld because of increased concerns regarding medical risk given her age and degree of aortic stenosis. Reassessment of the case confirmed severe stenosis with a valve area of 0.5 cm and a peak pressure gradient across the valve of 110 mm Hg. The ventricular ejection was normal at 70% however, and after a careful weighing of the risk of ECT treatment versus the risk of withholding ECT, it was decided to proceed with ECT in this case. In the event, ECT was very well tolerated by the patient, and she experienced a full remission of symptoms. She continues to receive maintenance ECT successfully at a once-per-month frequency. This case illustrates that neither age nor aortic stenosis by itself precludes ECT in the setting of severe depression. Rather, in each case, a careful weighing of the risks both of proceeding with and withholding ECT is warranted.
AB - We report the safe administration of a course of electroconvulsive therapy (ECT) in a 96-year-old woman with severe aortic stenosis. The patient experienced a relapse of her severe depression when ECT had been withheld because of increased concerns regarding medical risk given her age and degree of aortic stenosis. Reassessment of the case confirmed severe stenosis with a valve area of 0.5 cm and a peak pressure gradient across the valve of 110 mm Hg. The ventricular ejection was normal at 70% however, and after a careful weighing of the risk of ECT treatment versus the risk of withholding ECT, it was decided to proceed with ECT in this case. In the event, ECT was very well tolerated by the patient, and she experienced a full remission of symptoms. She continues to receive maintenance ECT successfully at a once-per-month frequency. This case illustrates that neither age nor aortic stenosis by itself precludes ECT in the setting of severe depression. Rather, in each case, a careful weighing of the risks both of proceeding with and withholding ECT is warranted.
KW - Aortic stenosis
KW - Electroconvulsive therapy
KW - Major depression
KW - Risk
UR - http://www.scopus.com/inward/record.url?scp=41849137620&partnerID=8YFLogxK
U2 - 10.1097/YCT.0b013e31814da9d5
DO - 10.1097/YCT.0b013e31814da9d5
M3 - Article
C2 - 18379343
AN - SCOPUS:41849137620
VL - 24
SP - 96
EP - 98
JO - Journal of ECT
JF - Journal of ECT
SN - 1095-0680
IS - 1
ER -