Anaesthetic management of a case of dilated cardiomyopathy for breast surgery with supraglottic airway device
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 7, Issue 3
Abstract
Background: Dilated cardiomyopathy (DCM) is defined as a myocardial disease characterised by left ventricle (LV) or biventricular dilatation, normal LV wall thickness, and systolic dysfunction. DCM is defined by two key factors: (a) Left ventricular ejection fraction (LVEF) less than 45% and/or fractional myocardial shortening less than 25% (b) Left Ventricular End Diastolic Diameter (LVEDD) greater than 117% by excluding presence or known cause of myocardial disease. DCM s considered as the most common form of non-ischemic cardiomyopathy. It is also the third common cause of heart failure. An EF of 20% and severe ventricular dysfunction is a predictor of sudden death in such patients. There are very few cases of perioperative management of patients with DCM. Each case showed a novel approach to management Case Report: We report a case of a 52-year-old Asian female with DCM who underwent breast cancer surgery. The patient had documented an EF of 20% while the adenosine scanning revealed no signs of stress-induced ischemia or arrhythmias. The patient was managed successfully with no intraoperative invasive monitoring using supraglotic airway device. The anaesthetic management of a patient with DCM is a challenge for the anaesthetist. Meticulous perioperative planning of patients with DCM is required for a safe and uneventful anaesthesia. The possibility of antipsychotic-induced DCM as a causative factor need to be investigated.
Authors and Affiliations
Nayana Kulkarni, Rajnish Nagarkar, Ravindra Tandale, Shital Patil, Shirish Deo
Keywords
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