Anestesia e Pesquisa Clínica
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Anesthetic Management of a Patient with Hypertrophic Obstructive Cardiomyopathy in a Place with Limited Resources

Shailendra Sigdel and Madindra Basnet

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.