English

Abstract

Dilated cardiomyopathy (DCM) is characterized by dilatation and impaired systolic function of one or both the ventricles. Malignant arrhythmias are the most common cause of death in DCM. Around 50% of cases of non-ischemic DCM are idiopathic. Anesthetic management of these patients is quite challenging. The anesthesiologist must have the knowledge of its pathophysiology, clinical features, diagnostic evaluation and treatment modalities. We report a successful anesthetic management of a patient with DCM who underwent proximal femur nailing (PFN). INTRODUCTION: Cardiomyopathies are a heterogeneous group of diseases of the myocardium associated with mechanical and /or electrical dysfunction that usually (but not invariably) exhibit inappropriate ventricular hypertrophy or dilatation and are due to a variety of causes that are frequently genetic. Cardiomyopathies either are confined to the heart or are part of generalized systemic disorders; often leading to cardiovascular death or progressive heart failure related disability. 1 dilated cardiomyopathy (DCM) is a primary myocardial disease of varied etiology. Although it was formerly called as congestive cardiomyopathy, the term dilated cardiomyopathy is now preferred. Because the earlier abnormality usually is ventricular enlargement and systolic contractile dysfunction with the signs and symptoms of congestive cardiac failure often (but not invariably) developing later.1,2 Prognosis of DCM is very bad with only 25%-40% patients surviving after 5 yrs. after the definitive diagnosis. 3 Anesthetic management of these patients is challenging as DCM is most commonly complicated by CHF and malignant arrhythmias (most common cause of death in DCM). 3 The anesthesiologist must have knowledge of its pathophysiology, clinical features diagnostic evaluation and the treatment modalities.