title: Anesthetic Management Guided by Transthoracic Echocardiography During Cesarean Delivery Complicated by Hypertrophic Cardiomyopathy.
abstract: We describe the management of a parturient woman with hypertrophic cardiomyopathy who developed a symptomatic accelerated idioventricular rhythm who required an urgent cesarean delivery at 32 weeks. Transthoracic echocardiography helped guide anesthetic management, including epidural dosing, fluid management, and phenylephrine infusion rates. This case demonstrates the application of transthoracic echocardiography to guide anesthetic management in a parturient woman at risk for cardiovascular compromise.
authors.affiliation: From the *Department of Women's & Obstetric Anesthesia, IWK Health Centre, Halifax, Nova Scotia, Canada; †Department of Pediatric Cardiology, IWK Health Centre, Halifax, Nova Scotia, Canada; ‡Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, Nova Scotia, Canada; and §Division of Cardiology, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Jaclyn M
authors.initials: JM
authors.lastname: DesRoches
authors.forename: Dolores Madeline
authors.initials: DM
authors.lastname: McKeen
authors.forename: Andrew
authors.initials: A
authors.lastname: Warren
authors.forename: Victoria M
authors.initials: VM
authors.lastname: Allen
authors.forename: Ronald B
authors.initials: RB
authors.lastname: George
authors.forename: Catherine
authors.initials: C
authors.lastname: Kells
authors.forename: Romesh
authors.initials: R
authors.lastname: Shukla
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical / Q000379:methods*; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000209:etiology; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods; D004452:Echocardiography; D005260:Female; D006801:Humans; D011247:Pregnancy; D011263:Pregnancy Trimester, Third