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Coronary artery bypass in a patient on lithium carbonate prophylaxis
Insights
This case study presents the first coronary artery bypass surgery in a patient on lithium carbonate. The patient experienced temporary delirium, but lithium prophylaxis was deemed safe and effective long-term.
Area of Science:
- Cardiology
- Psychiatry
- Pharmacology
Background:
- Lithium carbonate is a mood stabilizer used for bipolar disorder.
- Coronary artery bypass grafting (CABG) is a major cardiac surgical procedure.
- The safety of lithium carbonate during CABG is not well-established.
Observation:
- A patient on lithium carbonate prophylaxis underwent CABG.
- Post-cardiotomy delirium occurred on postoperative day 2.
- The delirium was deemed unrelated to the patient's underlying psychiatric condition.
Findings:
- The patient recovered from delirium without psychiatric relapse.
- Two-year follow-up showed resolution of psychological difficulties.
- No recurrence of somatic symptoms was observed.
Implications:
- Lithium carbonate prophylaxis can be continued during CABG.
- Appropriate patient monitoring is crucial during and after cardiac surgery.
- This case suggests lithium is safe for long-term cardiac patients.
Abstract:
What is thought to be the first case of coronary artery bypass in a patient on lithium carbonate prophylaxis is presented. A postcardiotomy delirium developed on day 2 and appeared unrelated to the underlying manic-depressive illness. A 2-year follow-up indicated apparent resolution of pre-existing psychological difficulties and no recurrence of somatic symptoms. It is suggested that lithium carbonate prophylaxis be continued with appropriate monitoring during coronary artery bypass procedures.