[Ebstein's anomaly in an adult patient detected by sinus tachycardia by preoperative anesthetic interview].
A 54-year-old man, scheduled for a clavicle fracture repair, appeared asymptomatic with 120 beats x min(-1) tachycardia and ECG abnormalities in preoperative anesthetic interview. He was not suffering from pain derived from clavicle fracture despite tachycardia. He was consulted with a cardiac physician. Downward displacement of tricuspid valve was detected by echocardiography and he was diagnosed Ebstein's anomaly. Right-left shunt did not exist, tricuspid regurgitation was grade I, and LV function was within normal ranges. Hence our anesthetic goal was to avoid arrhythmia, anesthesia was induced and maintained with propofol and remifentanil, and arterial pressure-based cardiac output monitor (FloTrac, Edwards Lifesciences, Irvine, CA, USA) was applied to measure cardiac output. Consequently, heart rate was controlled adequately, and intraoperative anesthetic course was uneventful. The number of adult patients with congenital heart disease has increased because techniques of echocardiography and surgical procedure have been improved. Anesthesiologists should be more aware of congenital heart disease in adults.
Nakamura
Mitsuyo
M
Department of Anesthesiology, Kansai Denryoku Hospital, Osaka 553-0003.
Nakasuji
Masato
M
Suh
Soon Hak
SH
Nomura
Masataka
M
Imanaka
Norie
N
Tanaka
Masuji
M
Kawashima
Hiroko
H
D000771:Anesthesia, Intravenous; D002968:Clavicle / Q000293:injuries; D004437:Ebstein Anomaly / Q000150:complications* / Q000175:diagnosis*; D004452:Echocardiography; D004562:Electrocardiography; D050723:Fractures, Bone / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D013616:Tachycardia, Sinus / Q000175:diagnosis* / Q000209:etiology*