Anesthesiological management of the pregnant patient with severe obstructive hypertrophic cardiomyopathy: Clinical case

Background: The authors describe a clinical case of a woman about to undergo surgery for severe obstructive hypertrophiccardiomyopathy. The condition causes altered ventricular compliance with consequent diastolic dysfunction and obstruction of partof the flow, and reduction of cardiac emission.Methods: The patient in her 38th week of pregnancy was a candidate for cesarean section and had multiple sclerosis, henceshe could not undergo spinal anesthesia. General anesthesia was performed with spontaneous breathing using a laryngeal mask.Results: During surgery there were no significant hemodynamic or saturation abnormalities, so no hemodynamic pharmacologicalsupport was needed.Conclusions: The authors believe general anesthesia with a laryngeal mask and spontaneous breathing were a safer approachthan positive pressure mechanical ventilation, which would worsen the degree of obstruction in the presence of obstructive hypertrophicmyopathy.