PMID- 27153810
OWN - NLM
STAT- MEDLINE
DCOM- 20161213
LR  - 20181113
IS  - 1471-244X (Electronic)
IS  - 1471-244X (Linking)
VI  - 16
DP  - 2016 May 6
TI  - A case of malignant catatonia with idiopathic pulmonary arterial hypertension 
      treated by electroconvulsive therapy.
PG  - 130
LID - 10.1186/s12888-016-0835-4 [doi]
LID - 130
AB  - 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.
FAU - Hobo, Mizue
AU  - Hobo M
AD  - 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.
AD  - Clinical Center for Pleasant Sleep, Medical Hospital, Tokyo Medical and Dental 
      University, Tokyo, Japan.
FAU - Uezato, Akihito
AU  - Uezato A
AD  - 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.
AD  - Clinical Center for Pleasant Sleep, Medical Hospital, Tokyo Medical and Dental 
      University, Tokyo, Japan.
FAU - Nishiyama, Mitsunori
AU  - Nishiyama M
AD  - Department of Pediatrics, Graduate School of Medical and Dental Sciences, Tokyo 
      Medical and Dental University, Tokyo, Japan.
FAU - Suzuki, Mayumi
AU  - Suzuki M
AD  - Department of Anesthesiology, Graduate School of Medical and Dental Sciences, 
      Tokyo Medical and Dental University, Tokyo, Japan.
FAU - Kurata, Jiro
AU  - Kurata J
AD  - Department of Anesthesiology, Graduate School of Medical and Dental Sciences, 
      Tokyo Medical and Dental University, Tokyo, Japan.
FAU - Makita, Koshi
AU  - Makita K
AD  - Department of Anesthesiology, Graduate School of Medical and Dental Sciences, 
      Tokyo Medical and Dental University, Tokyo, Japan.
FAU - Yamamoto, Naoki
AU  - Yamamoto N
AD  - 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.
FAU - Nishikawa, Toru
AU  - Nishikawa T
AD  - 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. tnis.psyc@tmd.ac.jp.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20160506
PL  - England
TA  - BMC Psychiatry
JT  - BMC psychiatry
JID - 100968559
SB  - IM
MH  - Catatonia/complications/*therapy
MH  - Electroconvulsive Therapy/*methods
MH  - Familial Primary Pulmonary Hypertension/complications/*therapy
MH  - Female
MH  - Humans
MH  - Young Adult
PMC - PMC4859975
OTO - NOTNLM
OT  - Electroconvulsive therapy
OT  - Idiopathic pulmonary arterial hypertension
OT  - Malignant catatonia
OT  - Pulmonary hypertensive crisis
OT  - Remifentanil
EDAT- 2016/05/08 06:00
MHDA- 2016/12/15 06:00
PMCR- 2016/05/06
CRDT- 2016/05/08 06:00
PHST- 2015/08/10 00:00 [received]
PHST- 2016/04/27 00:00 [accepted]
PHST- 2016/05/08 06:00 [entrez]
PHST- 2016/05/08 06:00 [pubmed]
PHST- 2016/12/15 06:00 [medline]
PHST- 2016/05/06 00:00 [pmc-release]
AID - 10.1186/s12888-016-0835-4 [pii]
AID - 835 [pii]
AID - 10.1186/s12888-016-0835-4 [doi]
PST - epublish
SO  - BMC Psychiatry. 2016 May 6;16:130. doi: 10.1186/s12888-016-0835-4.