Myocardial stunning (1, 2), a prolonged but reversible myocardial contractile dysfunction, has not been reported after electroconvulsive therapy (ECT). We describe a patient with myocardial stunning after ECT and the apparent prevention of this complication by combined alpha- and beta-blockade.
Case Report: A 77-year-old woman was admitted for major depression. She had no history of cardiac disease. Physical examination, routine laboratory tests, and a chest radiograph were negative. An electrocardiogram was normal (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