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A case of malignant catatonia with idiopathic pulmonary arterial hypertension treated by electroconvulsive therapy.
Hobo, Mizue; Uezato, Akihito; Nishiyama, Mitsunori; Suzuki, Mayumi; Kurata, Jiro; Makita, Koshi; Yamamoto, Naoki; Nishikawa, Toru.
Afiliação
  • Hobo M; Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
  • Uezato A; Clinical Center for Pleasant Sleep, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan.
  • Nishiyama M; Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
  • Suzuki M; Clinical Center for Pleasant Sleep, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan.
  • Kurata J; Department of Pediatrics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
  • Makita K; Department of Anesthesiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
  • Yamamoto N; Department of Anesthesiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
  • Nishikawa T; Department of Anesthesiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
BMC Psychiatry ; 16: 130, 2016 May 06.
Article em En | MEDLINE | ID: mdl-27153810
ABSTRACT

BACKGROUND:

Idiopathic pulmonary arterial hypertension (IPAH) is a progressive and fatal cardiovascular disease if left untreated. In patients with IPAH with psychiatric illness or other complications, careful attention is required when administering medical therapies that may affect their hemodynamics. Patients suffering from IPAH who undergo anesthesia and surgery have a high mortality and morbidity rate. We describe the treatment of intractable psychiatric symptoms with electroconvulsive therapy (ECT) in a patient with IPAH. CASE PRESENTATION A 23-year-old woman with IPAH and type I diabetes mellitus (DM) presented with malignant catatonia. Her heart function was classified as New York Heart Association (NYHA) class III. She required a rapid cure and ECT due to various psychiatric symptoms resistant to conventional medications. Pulmonary hypertensive (PH) crisis is the most concerning complication that can be induced by the sympathetic stimulation of ECT. To avoid PH crisis, we administered oxygen using a laryngeal mask and administered remifentanil for anesthesia. We also prepared standby nitric oxide for possible PH crisis, although it was ultimately not needed. With 14 ECT sessions, her malignant catatonia was ameliorated without physical complications.

CONCLUSION:

ECT is an acceptable option for the treatment of medication-refractory psychiatric disturbances in patients with IPAH, provided careful management is assured to prevent or address complications.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Catatonia / Eletroconvulsoterapia / Hipertensão Pulmonar Primária Familiar Limite: Adult / Female / Humans Idioma: En Ano de publicação: 2016 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Catatonia / Eletroconvulsoterapia / Hipertensão Pulmonar Primária Familiar Limite: Adult / Female / Humans Idioma: En Ano de publicação: 2016 Tipo de documento: Article