Anesthetic Management of a Patient with Hypertrophic Obstructive Cardiomyopathy in a Place with Limited ResourcesShailendra Sigdel* and Madindra Basnet
Division of Cardiothoracic Vascular Anesthesia, Cardiothoracic Vascular and Transplant Center, Institute of medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal
- *Corresponding Author:
- Shailendra Sigdel
Division of Cardiothoracic Vascular Anesthesia
Manmohan Cardiothoracic Vascular and Transplant Center
Institute of medicine, Tribhuvan University
Maharajgunj, Kathmandu, Nepal
E-mail: [email protected]
Received date: July 06, 2014; Accepted date: August 01, 2014; Published date: August 11, 2014
Citation: Sigdel S, Basnet M (2014) Anesthetic Management of a Patient with Hypertrophic Obstructive Cardiomyopathy in a Place with Limited Resources. J Anesth Clin Res 5:427. doi: 10.4172/2155-6148.1000427
Copyright: © 2014 Sigdel S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Hypertrophic Obstructive Cardiomyopathy (HOCM) is a rare genetic disorder of heart characterized by Left Ventricular Outflow Tract (LVOT) obstruction. Clinical presentation ranges from absence of symptoms to sudden death. A 62 year old patient presented with left carcinoma breast was scheduled for modified radical mastectomy. The patient was being treated for hypertension but was diagnosed as HOCM just two weeks prior. Anesthetic management of these patients presents considerable challenges and requires maintenance of desired hemodynamic parameters and management of specific complications. Factors like tachycardia, hypovolemia, vasodilation and increased cardiac contractility leads to exacerbation of the obstruction. We managed to successfully maintain the desired hemodynamics throughout the surgery and the patient was discharged home on the postoperative day.