RISK ASSESSMENT AND ANAESTHESIA IMPLICATIONS IN A CASE OF HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY FOR NON CARDIAC SURGERY

Abstract

Hypertrophic  Cardiomyopathy  with or without   left ventricular outflow  tract  obstruction  is characterised by Asymmetric hypertrophy of the interventricular septum causing intermittent obstruction of the left venticular out flow tract. Because Hypertrophic cardiomyopathy is the most common genetic cardiovascular disease it may present to the anaesthesiologist more often than anticipated. Surgery and Anesthesia often complicate the perioperative outcome of these patients. Aim of this case report is to highlight the importance of perioperative risk assessment of the patient and proper understanding of the pathophysiology of the disease for optimal anaesthetic management and postoperative outcome. A 62 yr old male who is a known case of Hypertrophic Obstructive Cardiomyopathy incidently diagnosed 9 yrs back had undergone ORIF with plating of left fibula following a trauma 5 yrs back under spinal anaesthesia. He has now been posted for cannulated cancellous screw removal.