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Indian Journal of Anesthesia and Analgesia 12(2):p 107-110, April -June 2025. | DOI: https://doi.org/10.21088/ijaa.2349.8471.12225.3
Case Report
The Hip Fix with a Heart Twist: Anaesthetic Complexity in Hemiarthroplasty for Dilated Cardiomyopathy
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Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Indian Journal of Anesthesia and Analgesia 12(2):p 107-110, April -June 2025. | DOI: https://doi.org/10.21088/ijaa.2349.8471.12225.3
How Cite This Article:
Salini R. Varma, Biju M.L. The Hip Fix with A Heart Twist: Anaesthetic Complexity in Hemiarthroplasty for Dilated Cardiomyopathy. Ind J Anesth Analg. 2025; 12(2): 107-110.Timeline
Received : January 28, 2025
Accepted : April 04, 2025
Published : June 30, 2025
Abstract
Anaesthetic management of a patient with Dilated Cardiomyopathy (DCM) or a non-cardiac surgery is always a challenge to the anaesthesiologist.1 DCM results in deterioration of the function of myocardium caused by either LV or biventricular dilatation or due to an impaired systolic function of one or both ventricles with impaired contractility2, thereby increasing the risk of perioperative cardiovascular complications. We present the successful anaesthetic management of hemiarthroplasty for a patient with severe DCM under Epidural anaesthesia. This abstract outlines the anaesthetic considerations and approach in a patient with DCM undergoing hemiarthroplasty under epidural anaesthesia. The case emphasizes the importance of preoperative optimization, including assessment of cardiac function, fluid status, and electrolyte balance. Epidural anaesthesia is a viable option in these cases due to its advantage in minimizing systemic stress responses and providing effective postoperative pain relief. Special attention was given to the titration of the epidural local anaesthetic to avoid hypotension, which could otherwise exacerbate heart failure symptoms. Continuous monitoring of cardiac output and blood pressure, alongside careful fluid management, was essential to prevent exacerbation of DCM-related complications. Postoperatively, epidural analgesia facilitated controlled pain relief, reduced the need for systemic opioids, thus lowering the risk of respiratory depression and other cardiovascular events. This report suggests that epidural anaesthesia, when carefully administered, can be a safe and effective anaesthetic technique in patients with DCM undergoing hemiarthroplasty, provided there is vigilant monitoring and individualized management of fluid balance, blood pressure, and cardiac function.
References
- 1. Kaur H., Khetarpal R., Aggarwal S. Dilated cardiomyopathy: An anaesthetic challenge. Journal of Clinical and Diagnostic Research: JCDR. 2013 Jun; 7(6): 1174.
- 2. Li M., Huang H. Anesthetic management of patients with dilated cardiomyopathy undergoing noncardiac surgery. Medicina. 2023 Aug 29; 59(9): 1567.
- 3. Mahmaljy H., Yelamanchili V.S., Singhal M. Dilated Cardiomyopathy. 2022 Aug 8. StatPearls Internet. Treasure Island (FL): StatPearls Publishing. 2022.
- 4. Wang Y., Jia H., Song J. Accurate classification of non-ischemic cardiomyopathy. Current Cardiology Reports. 2023 Oct; 25(10): 1299-317.
- 5. Raj R., Kumar M., Batra M. Anaesthetic management of a case of dilated cardiomyopathy for emergency appendectomy. Anesthesia Essays and Researches. 2014 Jan 1; 8(1): 105-7.
- 6. Pellicori P., Kaur K., Clark A.L. Fluid management in patients with chronic heart failure. Cardiac Failure Review. 2015 Oct; 1(2): 90.
Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
No conflicts of interest in this work.
About this article
Cite this article
Salini R. Varma, Biju M.L. The Hip Fix with A Heart Twist: Anaesthetic Complexity in Hemiarthroplasty for Dilated Cardiomyopathy. Ind J Anesth Analg. 2025; 12(2): 107-110.
Licence:
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
| Received | Accepted | Published |
|---|---|---|
| January 28, 2025 | April 04, 2025 | June 30, 2025 |
DOI: https://doi.org/10.21088/ijaa.2349.8471.12225.3
Keywords
Dilated cardiomyopathyHemiarthroplastyEpidural anaesthesiaSearch for Similar Articles
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Timeline
| Received | January 28, 2025 |
| Accepted | April 04, 2025 |
| Published | June 30, 2025 |
licence
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
