A 45-year-old man developed a psychotic depression 11 days after the surgical replacement of both aortic and mitral valves with prostheses. He was effectively treated with ECT beginning 27 days after the surgery. This case further confirms the feasibility of the early use of ECT in patients who have had heart surgery. Starting treatment when psychosis occurs alleviates many management problems. Close monitoring of the patient's cardiac status is important.
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