Anesthetic considerations for cesarean section in the parturient with familial cardiomyopathy.
Dilated cardiomyopathy (DCM) is a heart muscle disease characterized by ventricular dilatation and impaired systolic cardiac function. DCM is defined by the presence of: a) fractional myocardial shortening less then 25% (> 2 SD) and/or ejection fraction less than 45% (> 2 SD); and b) left ventricular end diastolic diameter (LVEDD) greater than 117% excluding any known cause of myocardial disease. Familial dilated cardiomyopathy (FDC) accounts for 20-48% of all DCM cases, and is defined by the presence of two or more affected relatives with DCM meeting the above diagnostic criteria or a relative of a DCM patient with unexplained sudden death before the age of 35 years. We herein present the first reported case in the literature of a parturient with FDC undergoing urgent Cesarean section (secondary to worsening cardiac function) and briefly highlight anesthetic considerations for parturients with this heart condition.
Wood
W L
WL
Department of Anesthesiology, University of California San Diego, San Diego, California, USA.
Kuczkowski
K M
KM
Beal
B R
BR
D000328:Adult; D000773:Anesthesia, Obstetrical / Q000379:methods*; D002311:Cardiomyopathy, Dilated / Q000601:surgery*; D002585:Cesarean Section; D005260:Female; D006801:Humans; D019990:Perioperative Care / Q000379:methods; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods