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<p>Hypertrophic cardiomyopathy (HCM) is a primary disease of the myocardium, characterised by increased myocardial thickening, myocardial remodelling and reduced chamber size. Disarrayed arrangement of myocardial fibres leads to asymmetric or localised thickening of myocardial segments. When the left ventricle (LV) wall thickness exceeds 15&#xa0;mm or more, with the septal to posterior wall thickness ratio above 1.3 either by echocardiography or cardiac magnetic resonance imaging (CMRI) without any identifiable causes, it is considered as HCM. Features common to HCM include dynamic left ventricle outflow tract obstruction (LVOTO), systolic anterior motion (SAM) of anterior mitral leaflet (AML) and mitral regurgitation (MR) with a posteriorly directed jet. Patients may be asymptomatic or present with dyspnoea, syncope, heart failure or sudden cardiac death (SCD) due to sustained ventricular tachycardia (VT). This review article highlights upon the anaesthetic considerations, intraoperative transoesophageal echocardiography (TEE) and postoperative management of obstructive HCM patient.</p>

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Anaesthesia and perioperative transoesophageal echocardiography in obstructive hypertrophic cardiomyopathy

  • 期刊论文

  • 发表日期：

    2025年12月15日

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  • Don Jose Palamattam,
  • Nagarjuna Panidapu,
  • Balaji Srimurugan,
  • Devika Poduval,
  • Tony Jose Joseph,
  • Jes Jose,
  • Thushara Madathil,
  • Divya P. Jacob,
  • Praveen Kerala Varma,
  • Praveen Kumar Neema

摘要

Hypertrophic cardiomyopathy (HCM) is a primary disease of the myocardium, characterised by increased myocardial thickening, myocardial remodelling and reduced chamber size. Disarrayed arrangement of myocardial fibres leads to asymmetric or localised thickening of myocardial segments. When the left ventricle (LV) wall thickness exceeds 15 mm or more, with the septal to posterior wall thickness ratio above 1.3 either by echocardiography or cardiac magnetic resonance imaging (CMRI) without any identifiable causes, it is considered as HCM. Features common to HCM include dynamic left ventricle outflow tract obstruction (LVOTO), systolic anterior motion (SAM) of anterior mitral leaflet (AML) and mitral regurgitation (MR) with a posteriorly directed jet. Patients may be asymptomatic or present with dyspnoea, syncope, heart failure or sudden cardiac death (SCD) due to sustained ventricular tachycardia (VT). This review article highlights upon the anaesthetic considerations, intraoperative transoesophageal echocardiography (TEE) and postoperative management of obstructive HCM patient.