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Anesthesia for older patients with hypertrophic cardiomyopathy: Is there cause for concern?

Timothy Angelotti1, Andrea Fuller, Luis Rivera

  • 1Department of Anesthesia, Stanford University School of Medicine, Stanford, CA 94305, USA. timangel@stanford.edu

Journal of Clinical Anesthesia
|September 21, 2005
PubMed

Insights

Late-onset hypertrophic cardiomyopathy (HCM) can be silent until advanced age. Preoperative echocardiography is crucial for diagnosing HCM in older patients presenting with systolic murmurs.

Area of Science:

  • Cardiology
  • Anesthesiology

Background:

  • Hypertrophic cardiomyopathy (HCM) is often undiagnosed in older adults.
  • Late-onset HCM may present subtly, with only a systolic murmur detected preoperatively.

Observation:

  • Two elderly patients with probable late-onset HCM were diagnosed via perioperative echocardiography.
  • Initial cardiac examination revealed only a systolic murmur in both cases.

Findings:

  • Perioperative echocardiography is effective for diagnosing HCM in older patients.
  • An algorithm for evaluating preoperative murmurs in suspected HCM is presented.

Implications:

  • Understanding HCM progression in older populations is vital for anesthetic management.
  • Tailored anesthetic strategies are necessary for elderly patients with HCM.

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