Key result
A 25-year-old male with schizophrenia and a history of recurrent pulmonary embolism developed acute-on-chronic pulmonary embolism following a single session of electroconvulsive therapy.
Case Report (n=1)
Highlights the complex theoretical and practical challenges in managing severe refractory psychosis in patients with a history of pulmonary embolism.
Pulmonary embolism (PE) is a potentially fatal condition. We describe the educative case of a young adult male, with a longstanding history of schizophrenia, who was receiving anticoagulant treatment because of repeated episodes of PE in the past. He presented with severe exacerbation of psychosis and did not respond to oral and parenteral antipsychotic medication during inpatient treatment. He was taken up for electroconvulsive therapy (ECT) and received a single ECT uneventfully. The ECT course had to be interrupted because of the unexpected development of a 4-day febrile illness, after which he experienced sudden onset breathlessness, which was diagnosed as acute-on-chronic PE. After the crisis resolved with 4 days of intensive care, he was managed with clozapine. We discuss concerns associated with the psychiatric management of patients with PE; special issues include the use of restraints, parenteral antipsychotic medications, anticoagulants, and ECT.
No takes yet. Share an insight, caveat, or question.
Chandele et al. (2015) conducted a case report in Schizophrenia complicated by pulmonary embolism (n=1). Electroconvulsive therapy (ECT) was evaluated. A 25-year-old male with schizophrenia and a history of recurrent pulmonary embolism developed acute-on-chronic pulmonary embolism following a single session of electroconvulsive therapy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: