Myocardial Stunning after Electroconvulsive Therapy

Myocardial stunning (1, 2), a prolonged but reversible myocardial contractile dysfunction, has not been re-ported after electroconvulsive therapy (ECT). We de-scribe a patient with myocardial stunning after ECT and the apparent prevention of this complication by com-bined alpha- and beta-blockade. Case Report A 77-year-old woman was admitted for major depres-sion. She had no history of cardiac disease. Physical examination, routine laboratory tests, and a chest ra-diograph were negative. An electrocardiogram was nor-mal (Figure 1A). After antidepressant therapy failed, ECT was begun. The patient was premedicated with glycopyrrolate. Anesthesia was induced with thiopental, 100 mg, and succinylcholine, 40 mg. Baseline blood pressure was 140/80 mm Hg and heart rate was 90 beats/min. Electroconvulsive therapy was initiated with