Severe unprovoked hypertrophic obstructive cardiomyopathy: anaesthetic concerns in patient undergoing parathyroidectomy

BMJ Case Rep. 2023 Sep 20;16(9):e254641. doi: 10.1136/bcr-2023-254641.

Abstract

This case highlights the role of an anaesthetist as a perioperative physician involved in diagnosing and optimising asymptomatic but severe hypertrophic obstructive cardiomyopathy. The modifications in anaesthetic technique for safe conduct of general anaesthesia during parathyroidectomy in a patient are also presented. These include those due to an extremely high left ventricular outflow tract obstruction with echocardiographic Doppler-derived maximum pressure gradient of 105 mm Hg at rest.

Keywords: Anaesthesia; Calcium and bone; Head and neck surgery.

Publication types

  • Case Reports

MeSH terms

  • Anesthesia, General
  • Anesthetics*
  • Cardiomyopathy, Hypertrophic* / complications
  • Cardiomyopathy, Hypertrophic* / diagnostic imaging
  • Cardiomyopathy, Hypertrophic* / surgery
  • Humans
  • Parathyroidectomy
  • Patients

Substances

  • Anesthetics