Anaesthetic Management of a Patient with Hypertrophic Obstructive Cardiomyopathy Undergoing Septal Myectomy

Hypertrophic Obstructive Cardio-Myopathy (HOCM) is a relatively common disorder that anesthesiologists encounter among patients in the perioperative period. It is autosomal dominant disorder having familial nature. Aim of this case report is to highlight the problems related to anaesthetic management of such patients. Patient admitted was a 50 years old male (weight 72 kilogram) with complaints of chest pain on exertion. Two dimensional Ecocardiography (2D Echo) showed Systolic Anterior Motion (SAM) of mitral valve, dynamic left ventricle outflow tract obstruction, severe constrictive left ventricular hypertrophy and interventricular septal thickness was 20mm. Optimal anaesthetic management in patients with HOCM involves monitoring adequate preload, optimal systemic vascular resistance and minimal outflow obstruction during intra operative period. Vigilant Intensive Care Unit (ICU) management and post operative care is mandatory for an uneventful recovery.