Anesthesia Management of Patients with Hypertrophic Obstructive Cardiomyopathy

Hypertrophic obstructive cardiomyopathy presents a challenge to the anesthesiologist. Because the condition is relatively prevalent, it is important for anesthesiologist to be aware of the pathophysiology. In this review, we draw upon case reports and studies of the anesthesia management of patients with hypertrophic obstructive cardiomyopathy to enhance medical decision making. The scope of this article ranges from the preoperative period, when the severity of the obstruction needs to be assessed; the intraoperative period, with monitoring, as well as general management guidelines; and finally, the postoperative period, when it is important to minimize the sympathetic response. Furthermore, we address the management of the obstetric patient, with particular focus on neuraxial anesthesia, and extrapolate how this type of anesthesia may be applied to the management of patients undergoing nonlaboring, noncardiac surgery.