Electroconvulsive therapy for depression following acute coronary syndromes: a concern for the anesthesiologist
| Autor: | Leili Pourafkari, Nader D. Nader, Nosratollah Pourafkari |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Acute coronary syndrome
education.field_of_study Depressive Disorder Major Myocardial ischemia business.industry medicine.medical_treatment Population Disease 030204 cardiovascular system & hematology medicine.disease 030227 psychiatry 03 medical and health sciences 0302 clinical medicine Anesthesiology and Pain Medicine Electroconvulsive therapy Mood Risk–benefit ratio Anesthesia medicine Humans Acute Coronary Syndrome education business Electroconvulsive Therapy Depression (differential diagnoses) |
| Zdroj: | Journal of clinical anesthesia. 31 |
| ISSN: | 1873-4529 |
| Popis: | The prevalence of depression in patients with cardiovascular disease is higher than general population and especially following an acute coronary syndrome (ACS), a significant number of patients report a wide spectrum of behavioral and mood changes attributable to clinical depression. Treatment of depression following ACS event is particularly challenging since most of the therapeutic modalities are associated with increasing the systemic sympathetic tone from neurogenic or pharmacologic sources. Increased activity of the adrenergic and catecholamine activity may further deter the myocardial oxygen supply and demand therefore treating depression should be carefully evaluated for its risk benefit ratio. Electroconvulsive therapy (ECT) is recommended for patients with severe depression, in whom behavioral and pharmacologic treatments have failed. Patients who refuse to take medications or present with any psychological emergency such as harming self or others, are also candidates for ECT. ECT is also associated with sudden surges of catecholamines and may cause recurrent myocardial ischemia and fatal dysrhythmias in patients convalescing from an ACS event. Herein, we provide an overview and practical guidelines for management of patients presented for ECT following ACS. |
| Databáze: | OpenAIRE |
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