The use of cardioselective beta-blockers in a patient with idiopathic hypertrophic subaortic stenosis and chronic obstructive pulmonary disease.
The beta-adrenergic receptor blocking drugs are commonly used in the treatment of patients with idiopathic hypertropic subaortic stenosis (IHSS). These drugs, however, are contraindicated in patients with chronic obstructive pulmonary disease (COPD). We report the anesthetic management of a patient with IHSS complicated by severe COPD. We concluded that the beta(1) selective, ultra-short acting beta-blocker, esmolol, can be used intraoperatively when both conditions are present. The pathophysiology and the commonly used anesthetic drugs and practices for treatment of patients with IHSS are reviewed.
Bekker
Alex
A
Department of Anesthesiology, New York University Medical Center, New York, NY 10016, USA. alex.bekker@med.nyu.edu
Sorour
Khaled
K
Miller
Sanford
S
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000368:Aged; D000758:Anesthesia; D000777:Anesthetics; D001794:Blood Pressure / Q000187:drug effects; D002312:Cardiomyopathy, Hypertrophic / Q000188:drug therapy* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D011412:Propanolamines / Q000627:therapeutic use*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D018570:Risk Assessment
D000319:Adrenergic beta-Antagonists; D000777:Anesthetics; D011412:Propanolamines; C036604:esmolol