title: Noonan syndrome: an anesthesiologist's perspective.
abstract: Noonan syndrome (NS) is one of the most common non chromosomal syndrome presenting to the cardiac anesthesiologist for the management of various cardiac lesions, predominantly pulmonary stenosis (PS) (80%) and hypertrophic obstructive cardiomyopathy (HOCM) (30%). The presence of HOCM in NS makes these children susceptible to acute congestive heart failure due to hemodynamic fluctuations, thus necessitating optimization of drug and fluid therapy, careful conduct of anesthesia and providing adequate analgesia in the perioperative period. We describe a case of four year old boy with NS who presented to us for the management of PS and HOCM. In our case, transesophageal echocardiography (TEE) played a major role in confirmation of the preoperative findings, detection of any new anomalies missed during the preoperative evaluation, intraoperative monitoring and assessment of the adequacy of repair in the immediate postoperative period. TEE provided invaluable help in taking critical surgical decisions, resulting in a favorable outcome.
authors.affiliation: Department of Cardiac Anesthesia, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Vikram
authors.initials: V
authors.lastname: Aggarwal
authors.forename: Vishwas
authors.initials: V
authors.lastname: Malik
authors.forename: Poonam Malhotra
authors.initials: PM
authors.lastname: Kapoor
authors.forename: Usha
authors.initials: U
authors.lastname: Kiran
mesh_terms: D000758:Anesthesia / Q000379:methods*; D002312:Cardiomyopathy, Hypertrophic / Q000601:surgery*; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D006801:Humans; D008297:Male; D009634:Noonan Syndrome / Q000150:complications*; D011666:Pulmonary Valve Stenosis / Q000601:surgery*