Tips in Anesthetic Techniques in Hypertrophic Cardiomyopathy

Abstract

Hypertrophic cardiomyopathy (HCM) is a common hereditary cardiomyopathy that affects up to 1 in 200 people in the general population [1,2] Patients with HCM usually have asymmetric or isolated areas of left ventricular hypertrophy >15 mm that aren't caused by anything else. The majority of patients have left ventricular outflow tract (LVOT) blockage at rest or with provocation owing to systolic anterior motion (SAM) of the mitral valve with mitral-ventricular septal contact. In addition, SAM causes mild to moderate mitral regurgitation (MR), which is usually oriented posteriorly [3, 4]. Up to 60% of HCM patients experience cardiac issues after surgery (myocardial infarction (MI), congestive heart failure (CHF), or both) [5]. We will discuss anesthetic technique selection during noncardiac surgery for individuals with a preoperative diagnosis of HCM and provide some tips in this review.