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Continuous Transthoracic Echocardiography in a 93-Year-Old Patient With Hypertrophic Cardiomyopathy During Electroconvulsive Therapy

Robinson, Albert R. III MD; Holbert, Richard MD; Modell, Jerome H. MD, DSc (Hon); Gravenstein, Nikolaus MD

doi: 10.1097/YCT.0b013e318223821b
Case Reports

Electroconvulsive therapy (ECT) is the treatment of choice for patients with a major depression disorder who have failed antidepressant therapy. Patients with hypertrophic cardiomyopathy (HCM) may have dynamic obstruction to left ventricular (LV) outflow. The effects on myocardial function during ECT and pretreatment with antihypertensive agents in patients with HCM and LV outflow tract obstruction gradients are unknown. We report the first use of continuous transthoracic echocardiography during ECT in a patient with HCM. We confirmed an outflow tract obstruction and showed a decrease in LV outflow tract gradients. Continuous transthoracic echocardiography monitoring using Doppler echocardiography during ECT is feasible.

From the University of Florida College of Medicine, Gainesville, FL.

Received for publication March 21, 2011; accepted April 25, 2011.

Reprints: Albert R. Robinson, III, MD, University of Florida College of Medicine, PO Box 100254, Gainesville, FL 32610-0254 (e-mail: arobinson@anest.ufl.edu).

The authors have no conflicts of interest.

All authors helped design the study, conduct the study, write the manuscript, and also AR Robinson III analyzed the data.

All authors approved the final manuscript.

This work was funded by institutional funds from the Departments of Anesthesiology and Psychiatry.

© 2011 Lippincott Williams & Wilkins, Inc.