Anaesthetic Management of a Patient with Hypertrophic Obstructive Cardiomyopathy for an Emergency Lower Segment Caesarean Section

This case report describes the successful management of a patient with hypertrophic obstructive cardiomyopathy (HOCM) coming for an emergency lower segment caesarean section. HOCM presents significant challenges in anaesthetic management, particularly during caesarean sections, due to the dynamic nature of left ventricular outflow tract (LVOT) obstruction. In pregnant patients, physiological changes like increased cardiac output and decreased vascular resistance exacerbate the condition, increasing the risk of perioperative complications. We report on the anaesthetic management of a 35-year-old primigravida coming for an emergency lower segment caesarean section using epidural anaesthesia with careful haemodynamic monitoring, which was employed for post-operative analgesia, minimising sympathetic stimulation. Continuous intraoperative monitoring, fluid management, and controlled administration of oxytocin were crucial in preventing LVOT obstruction and ensuring haemodynamic stability.