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Anaesthetic management of peripartum cardiomyopathy for emergency caesarean section: A case report

Year 2014, Volume: 36 Issue: 2, 252 - 255, 27.06.2014
https://doi.org/10.7197/cmj.v36i2.1008002261

Abstract

Abstract

Peripartum cardiomyopathy is a rare but life threatening condition. Anaesthetic management of a patient with peripartum cardiomyopathy for caesarean section is a major challenge for anaesthesiologist. Timely diagnosis of the condition, institution of appropriate medication regimen, a carefully chosen anaesthetic technique and vigilant perioperative monitoring are essential for optimizing outcome in these patients. The goals of anaesthetic management include maintenance of optimal ventricular preload and afterload while avoiding any anaesthesia induced myocardial depression.

Keywords: Peripartum cardiomyopathy, caesarean secion, anaesthetic management

 

Özet

Peripartum kardiyomiyopati nadir ama hayatı tehdit eden bir durumdur. Sezaryan için peripartum kardiyomiyopatili bir hastanın anestezi yönetimi, anestiziyolog için büyük bir risktir. Zamanında tanı koymak, uygun tedavi rejiminin kurgulanması, dikkatle seçilmiş anestezi tekniği ve perioperatif izlem bu hastalardaki sonucu optimize etmek için önemlidir. Anestezi yönetiminin amacı, anestezi ile uyarılan miyokardiyal depresyondan sakınırken optimal ventriküler “preload” ve “afterload” un idamesini sağlamaktır.

Anahtar sözcükler: Peripartum kardiyomiyopati, sezaryan, anestezi yönetimi

 

References

  • Ramachandran R, Rewari V, Trikha A. Anaesthetic management of patients with peripartum cardiomyopathy. J Obstet Anaesth Crit Care 2011; 1: 5-12. Soni B, Gautam PL, Grewal A, Kaur H. Anaesthetic management of two cases of peripartum cardiomyopathy. J Obstet Anaesth Crit Care 2011; 1: 41-5. Bansal T, Hooda S. Anaesthetic management of an elderly patient with dilated cardiomyopathy undergoing surgery for fracture of trochanter. Webmed Central Anaesthesia 2011; 2: WMC002567.
  • Nocoletti I, Tomei R, Zanotto G, Vecchia ED, Zorzi E, Vassanelli C. The beneficial effect of biventricular pacing on ventricular tachycardia in a patient with non ischemic cardiomyopathy. International Journal of Cardiology 2008; 126: 29-31.
  • Kaufman I, Bondy R, Benjamin A. Peripartum cardiomyopathy and thromboembolism; anesthetic management and clinical course of an obese, diabetic patient. Can J Anaesth 2003; 50: 161-5.
  • Peng TC, Chuah EC. Peripartum cardiomyopathy- a case report. Acta Anaesthesiol Sin 2001; 39: 47-51.
  • Domenech AP, Hernandez- Palazon J, Tortosa SJA, Burguillos LS, Alonso MB. Puerperal cardiomyopathy and pulmonary edema after caesarean section. Rev Esp Anestesiol Reanim 2002; 49: 156-9.
  • Shnaider R, Ezri T, Szmuk P, Larson S, Warters RD, Katz J. Combined spinalepidural anesthesia for cesarean section in a patient with peripartum dilated cardiomyopathy. Can J Anaesth 2001; 48: 681-3.
  • Velickovic IA, Leicht CH. Continuous spinal anaesthesia for cesarean section in a parturient with severe recurrent peripartum cardiomyopathy. Int J Obstet Anesth 2004; 13: 40-3.
  • Mcindoe AK, Hammond EJ, Babington PC. Peripartum cardiomyopathy presenting as cardiac arrest at induction of anaesthesia for emergency caesarean section. Br J Anaesth 1995; 75: 97-101.

ANAESTHETIC MANAGEMENT OF PERIPARTUM CARDIOMYOPATHY FOR EMERGENCY CAESAREAN SECTION- A CASE REPORT

Year 2014, Volume: 36 Issue: 2, 252 - 255, 27.06.2014
https://doi.org/10.7197/cmj.v36i2.1008002261

Abstract

Peripartum cardiomyopathy is a rare but life threatening condition. Anaesthetic management of a patient with peripartum cardiomyopathy for caesarean section is a major challenge for anaesthesiologist. Timely diagnosis of the condition, institution of appropriate medication regimen, a carefully chosen anaesthetic technique and vigilant perioperative monitoring are essential for optimizing outcome in these patients. The goals of anaesthetic management include maintenance of optimal ventricular preload and afterload while avoiding any anaesthesia induced myocardial depression.

References

  • Ramachandran R, Rewari V, Trikha A. Anaesthetic management of patients with peripartum cardiomyopathy. J Obstet Anaesth Crit Care 2011; 1: 5-12. Soni B, Gautam PL, Grewal A, Kaur H. Anaesthetic management of two cases of peripartum cardiomyopathy. J Obstet Anaesth Crit Care 2011; 1: 41-5. Bansal T, Hooda S. Anaesthetic management of an elderly patient with dilated cardiomyopathy undergoing surgery for fracture of trochanter. Webmed Central Anaesthesia 2011; 2: WMC002567.
  • Nocoletti I, Tomei R, Zanotto G, Vecchia ED, Zorzi E, Vassanelli C. The beneficial effect of biventricular pacing on ventricular tachycardia in a patient with non ischemic cardiomyopathy. International Journal of Cardiology 2008; 126: 29-31.
  • Kaufman I, Bondy R, Benjamin A. Peripartum cardiomyopathy and thromboembolism; anesthetic management and clinical course of an obese, diabetic patient. Can J Anaesth 2003; 50: 161-5.
  • Peng TC, Chuah EC. Peripartum cardiomyopathy- a case report. Acta Anaesthesiol Sin 2001; 39: 47-51.
  • Domenech AP, Hernandez- Palazon J, Tortosa SJA, Burguillos LS, Alonso MB. Puerperal cardiomyopathy and pulmonary edema after caesarean section. Rev Esp Anestesiol Reanim 2002; 49: 156-9.
  • Shnaider R, Ezri T, Szmuk P, Larson S, Warters RD, Katz J. Combined spinalepidural anesthesia for cesarean section in a patient with peripartum dilated cardiomyopathy. Can J Anaesth 2001; 48: 681-3.
  • Velickovic IA, Leicht CH. Continuous spinal anaesthesia for cesarean section in a parturient with severe recurrent peripartum cardiomyopathy. Int J Obstet Anesth 2004; 13: 40-3.
  • Mcindoe AK, Hammond EJ, Babington PC. Peripartum cardiomyopathy presenting as cardiac arrest at induction of anaesthesia for emergency caesarean section. Br J Anaesth 1995; 75: 97-101.
There are 8 citations in total.

Details

Primary Language English
Journal Section Case Reports
Authors

Teena Bansal

Sarla Hooda

Publication Date June 27, 2014
Published in Issue Year 2014Volume: 36 Issue: 2

Cite

AMA Bansal T, Hooda S. Anaesthetic management of peripartum cardiomyopathy for emergency caesarean section: A case report. CMJ. June 2014;36(2):252-255. doi:10.7197/cmj.v36i2.1008002261