The therapeutic options for treatment of critical aortic stenosis need to be weighed in terms
of the risk-benefit ratio to the patient. An important clinical consideration for treatment, in
general, is the presence or absence of any of the triad of classic symptoms of aortic stenosis;
angina, heart failure, or syncope. In the absence of any of these symptoms, the presence of
severe or critical aortic stenosis carries an excellent long-term prognosis. 20 Although our
patient had a fall in the past, this was not associated with loss of consciousness and was not
definitively caused by her aortic stenosis. In fact, during the periods between her ECT
sessions, our patient was able to perform normal activities without significant limitation. She
was able to tolerate her ECT sessions with careful consideration to the anesthetic issues
outlined above.