Serotonin syndrome in a postoperative cardiac surgical patient--a case report

Depression is common in patients with ischemic heart disease. According to mental health survey approximately one fifth of the patients with angiographic evidence of coronary artery disease have major depression. It is well recognized that stigmatization of mental disorders leads to stigmatized individuals to avoid treatment or to conceal treatment. We report a case of serotonin syndrome that occurred during postoperative period in a patient who underwent coronary artery bypass grafting. The patient was receiving 60 mg/day fluoxetine since the last four years which she and her attendants concealed during the preoperative evaluation. To our knowledge this is the first case in a postoperative patient reported in biomedical literature. We suggest that history taking should be done with special emphasis on antidepressant drug intake in patients suffering from coronary artery disease. If serotonin syndrome occurs in these patients aggressive and timely management can save the patient.