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Hypertrophic cardiomyopathy anesthesia

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https://www.readbyqxmd.com/read/26444142/slowed-atrial-and-atrioventricular-conduction-and-depressed-hrv-in-a-murine-model-of-hypertrophic-cardiomyopathy
#1
Wei-Wen Lim, Mathias Baumert, Melissa Neo, Pawel Kuklik, Anand N Ganesan, Dennis H Lau, Tatiana Tsoutsman, Christopher Semsarian, Prashanthan Sanders, David A Saint
Hypertrophic cardiomyopathy (HCM) is a common heritable cardiac disorder with diverse clinical outcomes including sudden death, heart failure, and stroke. Depressed heart rate variability (HRV), a measure of cardiac autonomic regulation, has been shown to predict mortality in patients with cardiovascular disease. Cardiac autonomic remodelling in animal models of HCM are not well characterised. This study analysed Gly203Ser cardiac troponin-I transgenic (TG) male mice previously demonstrated to develop hallmarks of HCM by age 21 weeks...
January 2016: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/26437557/-usefullness-of-beta-blocker-for-hemodynamic-changes-induced-by-uterotonic-drug-in-a-patient-with-hypertrophic-obstructive-cardiomyopathy-undergoing-elective-cesarean-section
#2
Yuri Tsukano, Michiko Sugita, Yoshihiro Ikuta, Tatsuo Yamamoto
Combined spinal-epidural anesthesia (CSEA) was given to a 27-year-old woman with hypertrophic obstructive cardiomyopathy (HOCM) for a selective cesarean section. After the injection of uterotonic drug via uterine muscle and a vein after delivery, the patient developed dyspnea, tachycardia, ST-change on elecrocardiogram and hypotension. It is important in HOCM patients to control heart rate and left ventricular contractile force. We started to infuse beta-blocker (landiolol, 10 μg x kg(-1) x min(-1)) and improved these symptoms of the patient...
June 2015: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26350523/parturients-with-hypertrophic-cardiomyopathy-case-series-and-review-of-pregnancy-outcomes-and-anesthetic-management-of-labor-and-delivery
#3
REVIEW
E Ashikhmina, M K Farber, K A Mizuguchi
BACKGROUND: Advances in understanding the pathogenesis, diagnosis and management of hypertrophic cardiomyopathy have resulted in increased longevity and a better quality of life of affected patients considering pregnancy. Several case series which focused predominantly on obstetric details have reported generally good outcomes. However, there remains a paucity of data on the specifics of obstetric anesthesia in women with hypertrophic cardiomyopathy. METHODS: After Institutional Review Board approval, we reviewed antepartum transthoracic echocardiograms, cardiology, obstetric, anesthetic, and nursing labor records with a focus on anesthesia for labor and delivery and early postpartum complications in patients with hypertrophic cardiomyopathy who delivered between January 1993 and December 2013...
November 2015: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/26059903/usefulness-and-growing-need-for-intraoperative-transthoracic-echocardiography-a-case-series
#4
Kotaro Hori, Tadashi Matsuura, Takashi Mori, Kiyonobu Nishikawa
BACKGROUND: Physician-performed transthoracic echocardiography (TTE) is still seldom used during anesthesia. Despite its various advantages, there are only a few reports of intraoperative TTE. We report 3 cases in which intraoperative TTE was successfully used. CASE PRESENTATION: A 75-year-old woman (Case 1) was scheduled for a posterior spinal fusion. When the wound was being closed, systolic blood pressure suddenly dropped to 30 mmHg. TTE revealed hypokinesis in the antero-septal region...
2015: BMC Anesthesiology
https://www.readbyqxmd.com/read/25927407/sudden-hypoxemia-after-uneventful-laparoscopic-cholecystectomy-another-form-of-sam-presentation
#5
Yoshihisa Fujita, Nobuyuki Kagiyama, Yuka Sakuta, Masatsugu Tsuge
BACKGROUND: Perioperative dynamic left ventricular outflow obstruction associated with systolic anterior motion of the mitral valve is well recognized as a cause for unexplained sudden hypotension in perioperative settings, even without underlying heart diseases such as hypertrophic obstructive cardiomyopathy. We treated a patient who experienced sudden hypoxemia without severe hypotension during emergence from anesthesia after an uneventful laparoscopic cholecystectomy. CASE PRESENTATION: A 65-year-old female patient with a history of hypertension presented a sudden decrease in oxygen saturation to 80% after an uneventful cholecystectomy...
April 16, 2015: BMC Anesthesiology
https://www.readbyqxmd.com/read/25827862/anesthesia-for-a-pediatric-patient-with-cardiofaciocutaneous-syndrome
#6
Humphrey Lam, Shannon Dare, Thanh Nguyen, Thomas Austin
Cardiofaciocutaneous syndrome is a rare syndrome that is characterized by distinct craniofacial features, cardiac abnormalities, and multiple organ involvement. Patients may present with pulmonary stenosis, hypertrophic cardiomyopathy, micrognathia, a short neck, laryngomalacia, and tracheomalacia; all of which may significantly impact the perioperative course of these patients. We describe a 6-year-old child with cardiofaciocutaneous syndrome presenting for an orthopedic procedure. He had an uneventful perioperative and postoperative course...
April 1, 2015: A & A Case Reports
https://www.readbyqxmd.com/read/25627778/high-throughput-phenotyping-of-left-and-right-ventricular-cardiomyopathy-in-calcineurin-transgene-mice
#7
COMPARATIVE STUDY
Kristin Moreth, Luciana Caminha Afonso, Helmut Fuchs, Valérie Gailus-Durner, Hugo A Katus, Raffi Bekeredjian, Lorenz Lehman, Martin Hrabě de Angelis
Consistent protocols for the assessment of diastolic and systolic cardiac function to assure the comparability of existing data on preclinical models are missing. Calcineurin transgene (CN) mice are a preclinical model for hypertrophic and failing hearts. We aimed at evaluating left and right ventricular structural and functional remodeling in CN hearts with an optimized phenotyping protocol. We developed a protocol using techniques and indices comparable to those from human diagnostics for comprehensive in vivo cardiac screening using high-frequency echocardiography, Doppler, electrocardiography and cardiac magnetic resonance (CMR) techniques...
April 2015: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/25429331/magnetic-resonance-imaging-and-multi-detector-computed-tomography-assessment-of-extracellular-compartment-in-ischemic-and-non-ischemic-myocardial-pathologies
#8
REVIEW
Maythem Saeed, Steven W Hetts, Robert Jablonowski, Mark W Wilson
Myocardial pathologies are major causes of morbidity and mortality worldwide. Early detection of loss of cellular integrity and expansion in extracellular volume (ECV) in myocardium is critical to initiate effective treatment. The three compartments in healthy myocardium are: intravascular (approximately 10% of tissue volume), interstitium (approximately 15%) and intracellular (approximately 75%). Myocardial cells, fibroblasts and vascular endothelial/smooth muscle cells represent intracellular compartment and the main proteins in the interstitium are types I/III collagens...
November 26, 2014: World Journal of Cardiology
https://www.readbyqxmd.com/read/24994732/hypertrophic-cardiomyopathy-part-ii-anesthetic-and-surgical-considerations
#9
REVIEW
Praveen Kerala Varma, Suneel Puthuvassery Raman, Praveen Kumar Neema
Hypertrophic cardiomyopathy (HCM) poses many unique challenges regarding the conduct of anesthesia and surgery. Adequate preload, control of sympathetic stimulation, heart rate, and increased afterload are required to decrease the left ventricular outflow tract obstruction. Comprehensive intraoperative transesophageal echocardiography (TEE) examination confirms the diagnosis, elucidates the pathophysiology, and identifies the various anomalies of mitral valve apparatus and allows assessment of the adequacy of surgery...
July 2014: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/24597212/difficult-anesthesia-management-in-a-case-of-living-donor-liver-transplantation-with-hypertrophic-obstructive-cardiomyopathy
#10
Takashi Kondo, Shinji Kusunoki, Masahiko Kuroda, Masashi Kawamoto
Liver transplantation with hypertrophic obstructive cardiomyopathy is associated with acute hemodynamic changes, which can exacerbate left ventricular outflow tract obstruction during surgery. Therefore, selection of general anesthetic agents is important, as most can result in hemodynamic instability by reducing systemic vascular resistance and blood pressure. We report successful anesthetic management in a case of living donor liver transplantation with hypertrophic obstructive cardiomyopathy using ketamine, propofol, and fentanyl to avoid vasodilation by anesthetic agents...
December 2013: Hiroshima Journal of Medical Sciences
https://www.readbyqxmd.com/read/24585793/systolic-anterior-motion-of-the-mitral-valve-masked-by-general-anesthesia
#11
Teruya Nakamura, Naosumi Sekiya, Taro Nakazato, Yoshiki Sawa
Systolic anterior motion of the mitral valve is usually associated with hypertrophic obstructive cardiomyopathy that results in left ventricular outflow tract obstruction. This is sometimes treated by volume loading or negative inotropics such as beta blockers. We report a rare case of dynamic systolic anterior motion of the mitral valve, in which a beta blocker did not diminish but anesthetic agents masked intraoperatively. The patient underwent mitral valve replacement, and left ventricular outflow tract obstruction was successfully treated...
February 2014: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/24558931/-anesthetic-management-for-patients-with-mitochondrial-disease
#12
REVIEW
Yousuke Imai, Yoshitsugu Yamada
Mitochondrial diseases are caused by a decrease in ATP production due to mutations of mitochondrial or mitochondria-related nuclear DNA. Their effects are likely to appear in tissues with a high energy demand, including skeletal muscle, nervous, and cardiovascular systems. Cardiac manifestations of mitochondrial diseases can be divided into cardiomyopathies, which are primarily hypertrophic and dilated cardiomyopathies, and electropathies, which are primarily conduction system disease and ventricular pre-excitation...
January 2014: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/24558927/-perioperative-management-for-patients-with-hypertrophic-cardiomyopathy
#13
REVIEW
Takeshi Omae
Hypertrophic cardiomyopathy is a common inherited cardiovascular disease present in one in 500 of the general population. It is caused by more than 1,400 mutations in 11 or more genes encoding proteins of the cardiac sarcomere. In the absence of evidence of any other cardiac or systemic disease that could have resulted in the hypertrophic event, diagnosis of hypertrophic cardiomyopathy requires a hypertrophied non-dilated left ventricle. It is associated with a significant risk for anesthesia. During anesthesia in patients diagnosed with hypertrophic cardiomyopathy, it is essential to maintain relatively slow heart rate, prevent hypovolemia, maintain or increase systemic vascular resistance, and avoid propofol as the sole anesthetic agent...
January 2014: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/24476936/hypertrophic-cardiomyopathy-implications-for-anesthesia
#14
M Vives, A Roscoe
Hypertrophic cardiomyopathy (HCM) is a genetic disorder and it is recognized as the most common cause of sudden cardiac death in the young, and an important substrate for disability at any age. Anesthetists may be confronted with clinically unrecognized HCM and must be prepared to anticipate the hemodynamic changes and cardiovascular instability that such patients may impose. When HCM patients are subjected to the stress of surgery, perioperative complications occur and can be devastating. Anesthesia providers need to be aware of the relevant pathophysiology and the mechanisms that may trigger or accentuate dynamic left ventricle outflow tract obstruction...
December 2014: Minerva Anestesiologica
https://www.readbyqxmd.com/read/24163456/perioperative-management-of-an-elderly-patient-of-hypertrophic-obstructive-cardiomyopathy-for-knee-arthroplasty-and-the-role-of-peripheral-nerve-blocks
#15
Sunny Rupal, Adarsh C Swami, Swati Jindal, Sneh Lata
This case report exemplifies how the anaesthetic technique of general anesthesia with continuous bilateral femoral nerve block for bilateral knee arthroplasty was well chosen for the management of perioperative complications in an elderly patient with hypertrophic obstructive cardiomyopathy (HOCM). A 69-year-old female patient of HOCM was scheduled for bilateral total knee replacement. Echocardiography revealed severe left ventricular outflow tract obstruction with peak systolic gradient of 56 mmHg. The surgery was conducted under general anaesthesia with invasive monitoring and bilateral continuous femoral nerve blocks for postoperative analgesia...
July 2013: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/23992655/alcohol-septal-ablation-in-a-patient-with-hypertrophic-obstructive-cardiomyopathy
#16
Shvetank Agarwal, Suvikram Puri, Hong Wang
No abstract text is available yet for this article.
April 2014: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/23869470/sudden-unexpected-death-during-pediatric-anesthesia-from-status-thymico-lymphaticus-to-silent-cardiomyopathy
#17
David J Steward
No abstract text is available yet for this article.
November 2013: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/23837180/hypertrophic-obstructive-cardiomyopathy-in-an-infant-with-an-adrenocortical-tumor
#18
Jakob Hauser, Stefan Riedl, Ina Michel-Behnke, Milen Minkov, Eva Perneczky, Ernst Horcher
Nonfamilial cardiomyopathies in childhood have been only sporadically ascribed to endocrine disorders. We report on a 4-month-old male infant presenting with Cushing's syndrome associated with excessive body weight (8.9 kg; >97th percentile) and features of virilization (Tanner stage 2 for pubic hair development). Abdominal sonography showed a large adrenal tumor. Echocardiography revealed myocardial hypertrophy with severe subaortic obstruction. Blood tests showed excessive androgen and cortisol serum levels with absent circadian rhythm as well as suppressed corticotropin...
August 2013: Pediatrics
https://www.readbyqxmd.com/read/23738413/anaesthetic-management-of-severe-hypertrophic-obstructive-cardiomyopathy-with-bronchial-asthma-for-emergency-caesarean-section
#19
M C Rajesh, Ravi Varma, P Lima, E K Ramdas
A 39-year-old primi and a known case of hypertrophic obstructive cardiomyopathy presented for emergency lower segment caesarean section. She was also an asthmatic with a recent exacerbation. She underwent uneventful lower segment caesarean section under general anaesthesia with lumbar epidural analgesia for postoperative pain relief. Anaesthetic agents and techniques were selected to suit the haemodynamic profile of severe hypertrophic obstructive cardiomyopathy in pregnancy. The case has been reported because of successful outcome in an emergency scenario with such high intraventricular gradients and omissions in the case so that it will be of benefit to readers who may happen to land up in similar situations...
October 2012: Journal of the Indian Medical Association
https://www.readbyqxmd.com/read/23530794/differentiating-athlete-s-heart-from-inherited-cardiac-pathology-the-challenge-of-repolarisation-abnormalities-presenting-during-anaesthesia
#20
P Dzendrowskyj, B Hamilton, M G Wilson
This case report describes an asymptomatic healthy male professional athlete who underwent general anaesthesia for a routine orthopaedic operation. Peri-procedure, pronounced ST elevation suggestive of myocardial ischaemia manifested on the electrocardiogram lasting for four hours post-procedure, upon which the athlete developed deep and diffuse inferolateral T-wave inversion. These changes resolved spontaneously and the patient remained clinically stable throughout. This case demonstrates the clinical conundrum facing anaesthetists attempting to differentiate between repolarisation anomalies that are commonly observed in high-level athletes and those of inherited cardiac pathology, namely hypertrophic cardiomyopathy, which is the leading cause of sudden cardiac death in young athletes...
March 2013: Anaesthesia and Intensive Care
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