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Journal of Obstrectic Anaesthesia and Critical Care
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CASE REPORT
Year : 2017  |  Volume : 7  |  Issue : 2  |  Page : 103-105

Anaesthetic management of a patient with hypertrophic obstructive cardiomyopathy posted for emergency lower segment caesarean section


Department of Anaesthesiology, Government Medical College Miraj and Sangli Civil Hospital, Sangli, Maharashtra, India

Correspondence Address:
Pradnya M Bhalerao
Department of Anaesthesiology, Government Medical College Miraj and Sangli Civil Hospital, Sangli, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joacc.JOACC_19_17

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Hypertrophic cardiomyopathy is characterised by asymmetric hypertrophy of the interventricular septum causing intermittent obstruction of the left ventricular outflow tract. This disease may present to the anaesthesiologist in an undiagnosed form during routine pre-operative visit. Surgery and anaesthesia often complicate the peri-operative outcome in this group of patients. A 22-year-old patient was brought in for emergency lower segment caesarean section. She was a diagnosed case of hypertrophic obstructive cardiomyopathy (HOCM) with severe left ventricular outflow tract obstruction and moderate subaortic stenosis. Factors such as tachycardia, hypovolemia, vasodilatation, and increased cardiac contractility leads to exacerbation of this obstruction. We managed this case successfully considering the pathological issues caused by the disease and pregnancy.


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