Which of the following is an absolute contraindication to electroconvulsive therapy (ECT)?

Increased intracranial pressure is considered an absolute contraindication to electroconvulsive therapy (ECT) due to the risks associated with the procedure. ECT involves inducing seizures through electrical stimulation of the brain, which can lead to a transient increase in intracranial pressure. For patients who already have elevated intracranial pressure, this additional increase can exacerbate their condition, potentially leading to serious complications such as brain herniation or further neurological damage.

In contrast, while congestive heart failure, pregnancy, and a history of myocardial infarction can influence the safety and management of ECT, they do not prohibit its use outright. Patients with these conditions may still undergo ECT, but careful considerations and monitoring of their cardiac or maternal health would be necessary to mitigate any risk. Therefore, the specific nature of increased intracranial pressure being potentially life-threatening during ECT establishes it as an absolute contraindication.