Key Points
- To document a severe adverse cardiac event occurring during electroconvulsive therapy modified by pre-treatment with a beta-adrenergic blocking agent.
- Clinical case evaluation of a single patient with hypertension, diabetes, and ischemic heart disease scheduled for electroconvulsive therapy.
- Pre-procedural administration of propranolol followed by subconvulsive electrical stimulation.
- The patient experienced cardiac arrest immediately following subconvulsive electrical stimulation under beta-adrenergic blockade.
- The clinical course demonstrates that beta-adrenergic antagonists may dangerously interact with electrical stimulation in patients with compromised cardiovascular systems.
Structured PICO
PPopulation1 hypertensive patient with a history of diabetes and ischemic heart disease
IInterventionPropranolol before electroconvulsive therapy (ECT)
OOutcomeCardiac arrestsafety
Caution is advised when combining beta-adrenergic blockade and ECT due to the risk of cardiac arrest.