Abstract
Intense emotional stress or fatigue has been reported to create vulnerable environment for cardiac arrhythmia with or without underlying heart disease. We encountered a case of masked depression characterized by refractory ventricular arrhythmias and plural sensory disturbances. Although intensive cardiac examinations including left ventriculography detected no evidence of structural heart disease, administration of 4 kinds antiarrhythmic agents brought no improvements but side effects. Psychological evaluation revealed that the patient made a high score of SDS (Self-rating Depression Scale) and duplicated mourning episodes suggestive of depressive state. A Iow dose of Maprotiline produced marked suppresion of VPC (ventricular premature contraction) and relief of both paresthesia and parosmia. Our experience implicates that-in the absence of organic heart disease-a depressive emotional state may participate in the genesis of ventricular arrhythmias.
