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The basic definition and anesthesia management of dilated cardiomyopathy

2021.08.30 / Monday
The basic definition and anesthesia management of dilated cardiomyopathy





Definition of dilated cardiomyopathy:

Primary cardiomyopathy of unknown cause. Left or right ventricle or bilateral ventricle enlargement, accompanied by hyposystolic function, with or without congestive heart failure. Ventricular arrhythmia (disorder) is more common, and the disease is progressively aggravated, and death can occur at any stage of the disease.


Pathology of dilated cardiomyopathy:

The weight of the heart increases, the ventricular septum is generally not thickened, mural thrombus can be seen in the heart, the coronary arteries are generally normal, the myocardium is fibrotic, and the conduction is impaired.


Clinical manifestations of dilated cardiomyopathy:

Mainly heart failure, impaired activity tolerance, insufficient blood supply to the brain, embolism of the arterial system, and arrhythmia.


Summary of anesthesia management for dilated cardiomyopathy


The key points of anesthesia management for patients with dilated cardiomyopathy in non-cardiac surgery include:
Intraoperative fluid management needs to be precise, maintain a balance of in and out, ensure urine output, and reduce pre-load;


If the operation time is long, a medical temperature probe needs to be used to monitor the patient's temperature changes in real time;


If there is too much blood loss during the operation, pay attention to replenishing the volume and correcting electrolyte disturbances to ensure myocardial perfusion and electrical stability of myocardial cells to prevent arrhythmia;


As patients with dilated cardiomyopathy have poor heart function and intolerance to hypercapnia, adequate ventilation and oxygen should be ensured to avoid carbon dioxide retention;


Patients with dilated cardiomyopathy are prone to severe circulatory depression and hypotension during the operation. During the operation, appropriate cardiovascular drugs should be selected, and the hypotension should be treated in time to reduce the incidence of postoperative complications.