Abstract
The incidence of ischemic heart disease (IHD) is increasing and it is the leading cause of morbidity and mortality worldwide.1 These patients have increased risk of myocardial ischemia, myocardial infarction (MI), conduction disturbances and cardiac arrest perioperatively. Preoperative cardiovascular assessment and prediction of short- and long-term risks affects the perioperative anaesthetic management and also surgical decision making. Risk factors include recent MI, congestive cardiac failure, peripheral vascular disease, angina pectoris, diabetes mellitus (DM), hypertension, renal dysfunction, age, obesity and sedentary lifestyle.2 The choice of anaesthesia is general anaesthesia so that myocardial oxygen supply can be kept greater than demand by preventing tachycardia and high blood pressures, which can lead to ischemia.3 Few studies have shown that Epidural anaesthesia can decrease cardiac morbidity and mortality in IHD patients. We report a successful anaesthetic management of IHD with ejection fraction of 30 % posted for fracture femur surgery under Combined Spinal Epidural (CSE) anaesthesia.
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