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, ?uid status, and electrolyte balance. Epidural anaesthesia is a viable option in these cases due to its advanta ge 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 ?uid 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 ?uid balance, blood pressure, and cardiac function.