Safely Navigating Patients With Hypertrophic Obstructive Cardiomyopathy (HOCM) During Anaesthesia

Abstract

In order to have an uneventful peri-operative period it is imperative for anaesthesiologist to maintain patients in perfect haemodynamics. But patients underlying cardiac status has lot to do with the patient’s peri-operative course. Hypertrophic obstructive cardiomyopathy (HOCM) is one such condition which is relatively common with an incidence of 1 in 500. In order to safely cruise patients during anaesthesia, it is important for anaesthesiologists to have a basic understanding of the pathophysiology, haemodynamic changes and anaesthetic implications of disease. If adequate anticipation and peri-operative care not taken, anaesthesia and surgery can complicate the peri-operative outcome. Intraoperative factors like increase in myocardial contractility, tachycardia, hypotension or vasodilation can precipitate an exacerbation of the obstruction.