Hypotension on induction: anaphylaxis or cardiac failure?

Area of Science:

• Anesthesiology
• Cardiology
• Immunology

Background:

• Hypotension following anesthesia induction necessitates accurate etiological diagnosis for appropriate management.
• Anaphylaxis is a potential cause of perioperative hypotension, particularly in patients with compromised cardiac function.

Observation:

• A patient with severe cardiac disease experienced hypotension after anesthesia induction.
• Echocardiography was utilized to aid in the diagnosis of the underlying cause.

Findings:

• The hypotension was attributed to anaphylaxis.
• The patient received immediate cardiovascular resuscitation, epinephrine, vasopressors, and antihistamines.
• The patient's condition improved following the interventions.

Implications:

• This case underscores the importance of considering anaphylaxis in patients with cardiac disease presenting with hypotension post-anesthesia.
• Prompt diagnosis and multi-modal treatment, including resuscitation and pharmacotherapy, are crucial for favorable outcomes.
• Echocardiography can be a valuable tool in the rapid assessment of cardiac function during hypotensive events.