Indian Journal of Anaesthesia  
About us | Editorial board | Search | Ahead of print | Current Issue | Past Issues | Instructions
Home | Login  | Users Online: 2965  Print this pageEmail this pageSmall font sizeDefault font sizeIncrease font size    


CASE REPORT
Year : 2007  |  Volume : 51  |  Issue : 2  |  Page : 134

Anaesthesia management of a patient with hypertrophic obstructive cardiomyopathy undergoing Morrow's septal myectomy


1 Senior Resident, Department of Cardio thoracic surgery, AIIMS, India
2 Assoc. Prof., Department of Cardio thoracic surgery, AIIMS, India
3 Additional Prof., Department of Cardio thoracic surgery. AIIMS, India
4 Prof. & Head. Department of Cardiac Anaesthesia, AIIMS, India

Correspondence Address:
Poonam Malhotra Kapoor
CNC, AIIMS, New Delhi
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


Rights and PermissionsRights and Permissions

Hypertrophic obstructive cardiomyopathy (HOCM) is a rare disorder. There is paucity of literature on anaesthetic management of this disorder. Aim of this case report is to highlight the anaesthetic problems encountered during management of such patients. A thirty-five year old male was admitted with atypical chest pain for last one year. X-ray chest revealed cardiomegaly (CT ratio 0.6). Electrocardiographic findings were left axis deviation with left ventricular hypertrophy. On echocardiography, there was moderate mitral regurgitation (MR), systolic anterior motion (SAM) of anterior mitral leaflet and prominent systolic narrowing of left ventricle cavity. Transoesophageal echocardiography (TOE) also showed an anomalous muscle bundle stretching into LV causing obstruction. Preload was kept high. Systemic vascular resistance (SVR) was maintained, avoiding use of vasodilators and inotropes. Morrow's septal myectomy was done. Anomalous muscle bundle was excised. On postoperative TOE, there was no MR and no obstruction. Optimal anaesthetic management in such patients involves maintaining adequate preload, systemic vascular resistance and minimal outflow obstruction. Other considerations are to maintain haemodynamic stability, sinus rhythm and afterload. Transoesophageal echocardiography is an extremely useful monitoring device in such patients.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed2880    
    Printed112    
    Emailed1    
    PDF Downloaded377    
    Comments [Add]    

Recommend this journal