Sudden cardiac death is disproportionately common among patients with mental disorders. This review focuses on schizophrenia, depression, and anxiety disorders, providing a comprehensive summary of the relationship between these conditions and ischemic heart disease and fatal arrhythmia. Schizophrenia, depression, and anxiety disorders involve mechanisms that may trigger the onset of circulatory issues. Furthermore, there is growing evidence that the psychotropic medications commonly used to treat these conditions may contribute to the development of cardiovascular complications. Several factors have been implicated in this increased risk. Patients with mental disorders often exhibit genetic predispositions, autonomic nervous system dysfunction, inflammatory responses, and heightened stress responses, all of which can negatively affect cardiovascular health. Unhealthy lifestyle habits, such as smoking, poor diet, and lack of physical activity, also play a significant role. Moreover, psychotropic medications can influence neurotransmitter systems, such as those involving monoamines, and block sodium and potassium channels, contributing to the risk of cardiac arrhythmia and other cardiovascular complications. Given these complexities, regular electrocardiogram monitoring is crucial for patients on psychotropic medications, particularly for patients receiving treatments known to affect cardiac function. Preventive strategies, including lifestyle modification and careful medication management, are necessary to reduce the incidence of sudden cardiac events. A deeper understanding and closer monitoring of these risks may improve the management of both mental and physical health in patients with mental disorders.

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Abstract: Older people often have some systemic comorbidities. monitored anesthesia care（ MAC） during dental treatment is very important for older patients with systemic diseases. This study aimed to understand preoperative cardiovascular comorbidity and intraoperative cardiovascular complications in older patients scheduled dental treatment, who underwent MAC by the board certified dental anesthesiology specialist. We conducted a retrospective survey based on anesthetic records in the older patients who underwent MAC from 2015 through 2017 at the department of dental anesthesiology in our hospital. The average number of diseases suffered by those aged ≥ 65 was 2.9. Cardiovascular comorbidities were the most common occurrence in patients aged ≥ 65 years（ n = 614） and the most frequently occurring disease was hypertension. 1.8%（ n=11） of patients aged ≥ 65 postponed their dental treatment because of cardiovascular complications. The incidence of intraoperative cardiovascular complications was 0.3%（ n=2）: one case of the patient aged 65-74 with arrhythmia and another case of the patient aged ≥ 75 with marked hypotension. It was suggested that our attention should be paid to incidence of intraoperative cardiovascular complications during dental treatment in the older patients with cardiovascular comorbidities.

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  An 87-year-old woman underwent emergency surgery for acute aortic dissection 2 years ago. She was admitted to the hospital with a diagnosis of suture abscess and underwent suture removal and debridement. A culture of the pus showed no bacteria. However, the swelling was observed again, and computed tomography showed further enlargement of the fluid accumulation around the graft, and the fluid was found to be continuous to the anterior surface of the sternum. The patient underwent surgery with a diagnosis of mediastinitis. Pus was also found around the graft. A culture of the pus did not detect any bacteria. She underwent omentopexy. She was discharged 19 days after the operation without any infectious complications.

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