Abstract
We describe our experience with general anesthesia in a patient with a diagnosis of hypertrophic cardiomyopathy (HCM). The patient was a 63-year-old woman who had been given a diagnosis of HCM and hypertension and was receiving oral medication. She was scheduled to undergo radical maxillary sinus surgery for a diagnosis of maxillary sinusitis. A preoperative resting ECG showed a pulse rate of 45 beats/min and ST depression. A Holter ECG revealed occasional SVPCs and VPCs and 6 consecutive SVPCs. Echocardiography (ECG) demonstrated wall thickening, and chest x-ray films showed cardiac hypertrophy with a CTR of 56%. Atropine and midazolam were injected intramuscularly as premedication. Anesthesia was gradually induced with nitrous oxide, oxygen, sevoflurane, SCC, and vecuronium. Anesthesia was maintained with nitrous oxide, oxygen and sevoflurane. There were no major hemodynamic changes intraoperatively, and the scheduled procedure was completed with no alterations in the ECG. It is important to diagnose the presence and evaluate the severity of HCM in advance to safely administer seneral anesthesia to patients with HCM. It is necessary to maintain a favorable pressure gradient in the left ventricular outflow tract to ensure effective anesthesia management. We decided to perform general anesthesia in our patient on the basis of the results of the preoperative tests, and the scheduled treatment could be completed without any serious complications.
