{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T04:25:23Z","timestamp":1754108723451},"reference-count":25,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018]]},"abstract":"<jats:p>Stabilization of circulatory dynamics is a critical issue in the anesthetic management of patients with hypertrophic cardiomyopathy (HCM). In this report, we managed general anesthesia for a 74-year-old male patient with nonobstructive HCM who developed circulatory instability intraoperatively. Severe bradycardia measuring 35 beats\/min and hypotension measuring 78 mm Hg systolic were observed during surgery. Using stroke volume variation and stroke volume from the FloTrac as indices, successful circulatory management was performed with dopamine. The hypotension and bradycardia were thought to be the result of methyldigoxin and possibly associated with our perioperative management. Cardiology consult should have been obtained. We demonstrated that the FloTrac can be beneficial in diagnosing and managing cardiovascular instability and administration of dopamine in the anesthetic management of nonobstructive HCM patients.<\/jats:p>","DOI":"10.2344\/anpr-65-03-12","type":"journal-article","created":{"date-parts":[[2018,9,20]],"date-time":"2018-09-20T21:21:11Z","timestamp":1537478471000},"page":"192-196","source":"Crossref","is-referenced-by-count":6,"title":["General Anesthetic Management of a Patient With Hypertrophic Cardiomyopathy for Oral Surgery: Did Digitalis Contribute to Bradycardia?"],"prefix":"10.2344","volume":"65","author":[{"given":"Aiji","family":"Sato(Boku)","sequence":"first","affiliation":[{"name":"Associate Professor, Department of Anesthesiology, Aichi Gakuin University School of Dentistry, Nagoya, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maki","family":"Morita","sequence":"additional","affiliation":[{"name":"Resident, Department of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MinHye","family":"So","sequence":"additional","affiliation":[{"name":"Assistant Professor, Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Tamura","sequence":"additional","affiliation":[{"name":"Assistant Professor, Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumiaki","family":"Sano","sequence":"additional","affiliation":[{"name":"Assistant Professor, Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuyuki","family":"Shibuya","sequence":"additional","affiliation":[{"name":"Professor, Department of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Harada","sequence":"additional","affiliation":[{"name":"Professor, Department of Anesthesiology, Aichi Gakuin University School of Dentistry, Nagoya, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuya","family":"Sobue","sequence":"additional","affiliation":[{"name":"Professor, Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1191","reference":[{"key":"i0003-3006-65-3-192-b01","series-title":"Cardiol Res","first-page":"46","article-title":"Apical hypertrophic cardiomyopathy among non-Asians: a case series and review of the literature","volume":"7","author":"Karan \n              K,","year":"2016","unstructured":"Karan \n              K, \n            \n            \n              Amal \n              C, \n            \n            \n              Matthew \n              CE, \n            \n            \n              Amish \n              S. \n            \n          \n          Apical hypertrophic cardiomyopathy among non-Asians: a case series and review of the literature. Cardiol Res. 2016;7:46\u201350."},{"key":"i0003-3006-65-3-192-b02","series-title":"Circulation","first-page":"1541","article-title":"Prevalence, clinical significance, and natural history of left ventricular apical aneurysms in hypertrophic cardiomyopathy","volume":"118","author":"Maron \n              MS,","year":"2008","unstructured":"Maron \n              MS, \n            \n            \n              Finley \n              JJ, \n            \n            \n              Bos \n              JM, \n            \n            et al. \n          Prevalence, clinical significance, and natural history of left ventricular apical aneurysms in hypertrophic cardiomyopathy. Circulation. 2008;118:1541\u20131549."},{"key":"i0003-3006-65-3-192-b03","series-title":"Jpn Heart J","first-page":"611","article-title":"Giant t wave inversion as a manifestation of asymmetrical apical hyper trophy (AAH) of the left ventricle. 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Jpn Heart J. 1976;17:611\u2013629."},{"key":"i0003-3006-65-3-192-b04","series-title":"Am J Cardiol","first-page":"401","article-title":"Hypertrophic nonobstructive cardiomyopathy with giant negative T waves (apical hypertrophy): ventriculographic and echocardiographic features in 30 patients","volume":"44","author":"Yamaguchi \n              H,","year":"1979","unstructured":"Yamaguchi \n              H, \n            \n            \n              Ishimura \n              T, \n            \n            \n              Nishiyama \n              S, \n            \n            et al. \n          Hypertrophic nonobstructive cardiomyopathy with giant negative T waves (apical hypertrophy): ventriculographic and echocardiographic features in 30 patients. 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Circ Control. 2011;32:181\u2013184."},{"key":"i0003-3006-65-3-192-b08","series-title":"AANA J Course","first-page":"59","article-title":"Should I continue or discontinue that medication?","volume":"77","author":"Nagelhout \n              J,","year":"2009","unstructured":"Nagelhout \n              J, \n            \n            \n              Elisha \n              S, \n            \n            \n              Waters \n              E. \n            \n          \n          Should I continue or discontinue that medication?\n          AANA J Course. 2009;77:59\u201373."},{"key":"i0003-3006-65-3-192-b09","series-title":"Anesth Analg","first-page":"557","article-title":"Perioperative management of chronic heart failure","volume":"103","author":"Groban \n              L,","year":"2006","unstructured":"Groban \n              L, \n            \n            \n              Butterworth \n              J. \n            \n          \n          Perioperative management of chronic heart failure. 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Curr Probl Cardiol. 1993;18:639\u2013704."},{"key":"i0003-3006-65-3-192-b12","series-title":"Jpn Circ J","first-page":"54","article-title":"Effect of diltiazem on left ventricular isovolumic relaxation time in patients with hypertrophic cardiomyopathy","volume":"47","author":"Nagano \n              M,","year":"1983","unstructured":"Nagano \n              M, \n            \n            \n              Omote \n              S, \n            \n            \n              Takizawa \n              A, \n            \n            \n              Yasue \n              H. \n            \n          \n          Effect of diltiazem on left ventricular isovolumic relaxation time in patients with hypertrophic cardiomyopathy. Jpn Circ J. 1983;47:54\u201358."},{"key":"i0003-3006-65-3-192-b13","series-title":"Prog Cardiovasc Dis","first-page":"475","article-title":"WintersSL. 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Am J Cardiol. 1988;62:1252\u20131255."},{"key":"i0003-3006-65-3-192-b17","series-title":"Anesthesiology","first-page":"498","article-title":"Systolic blood pressure variation is a sensitive indicator of hypovolemia in ventilated dogs subjected to graded hemorrhage","volume":"67","author":"Peel \n              A,","year":"1987","unstructured":"Peel \n              A, \n            \n            \n              Pizow \n              R, \n            \n            \n              Cotev \n              S. \n            \n          \n          Systolic blood pressure variation is a sensitive indicator of hypovolemia in ventilated dogs subjected to graded hemorrhage. Anesthesiology. 1987;67:498\u2013502"},{"key":"i0003-3006-65-3-192-b18","series-title":"J Jpn Soc Clin Anesth","first-page":"81","article-title":"Clinical usefulness of the Flo Trac system-efficacy of arterial pressure-based cardiac output and stroke volume variations","volume":"31","author":"Isao \n              F.","year":"2011","unstructured":"Isao \n              F. \n            \n          \n          Clinical usefulness of the Flo Trac system-efficacy of arterial pressure-based cardiac output and stroke volume variations. J Jpn Soc Clin Anesth. 2011;31:81\u201390."},{"key":"i0003-3006-65-3-192-b19","series-title":"J Jpn Soc Clin Anesth","first-page":"398","article-title":"Circulatory, fluid management and patient outcome","volume":"30","author":"Yoshifumi \n              K.","year":"2011","unstructured":"Yoshifumi \n              K. \n            \n          \n          Circulatory, fluid management and patient outcome. J Jpn Soc Clin Anesth. 2011;30:398\u2013409."},{"key":"i0003-3006-65-3-192-b20","series-title":"J Clin Anesth (Jpn)","first-page":"535","article-title":"Efficacy and future of new monitoring parameters","volume":"33","author":"Kenji \n              I,","year":"2009","unstructured":"Kenji \n              I, \n            \n            \n              Toshiyasu \n              S. \n            \n          \n          Efficacy and future of new monitoring parameters. J Clin Anesth (Jpn). 2009;33:535\u2013541."},{"key":"i0003-3006-65-3-192-b21","series-title":"J Clin Anesth (Jpn)","first-page":"1179","article-title":"Intraoperative fluids management using stroke volume variation as an indicator radical prostatectomy","volume":"36","author":"Shunsuke \n              S,","year":"2009","unstructured":"Shunsuke \n              S, \n            \n            \n              Sumie \n              E, \n            \n            \n              Yuuichiro \n              K, \n            \n            \n              Matsuhisa \n              S, \n            \n            \n              Takero \n              A, \n            \n            \n              Yasuhisa \n              O. \n            \n          \n          Intraoperative fluids management using stroke volume variation as an indicator radical prostatectomy. J Clin Anesth (Jpn). 2009;36:1179\u20131182."},{"key":"i0003-3006-65-3-192-b22","series-title":"J Jpn Soc Clin Anesth","first-page":"884","article-title":"Emergency anesthesia in a patient with von Hippel-Lindau syndrome who underwent pheochromocytectomy and the resection of cerebellar hemangioblastoma","volume":"31","author":"Kohei \n              F,","year":"2011","unstructured":"Kohei \n              F, \n            \n            \n              Yasuo \n              T, \n            \n            \n              Tomohiro \n              S, \n            \n            \n              Michiko \n              K, \n            \n            \n              Katsuya \n              T, \n            \n            \n              Shuzo \n              O. \n            \n          \n          Emergency anesthesia in a patient with von Hippel-Lindau syndrome who underwent pheochromocytectomy and the resection of cerebellar hemangioblastoma. J Jpn Soc Clin Anesth. 2011;31:884\u2013887."},{"key":"i0003-3006-65-3-192-b23","series-title":"Br J Anaesth","first-page":"451","article-title":"Performance of a minimally invasive uncalibrated cardiac output monitoring system (Flotrac\/Vigileo) in haemodynamically unstable patients","volume":"100","author":"Comton \n              FD,","year":"2008","unstructured":"Comton \n              FD, \n            \n            \n              Zukunft \n              B, \n            \n            \n              Hoffman \n              C, \n            \n            \n              Zidek \n              W, \n            \n            \n              Schaefer \n              JH. \n            \n          \n          Performance of a minimally invasive uncalibrated cardiac output monitoring system (Flotrac\/Vigileo) in haemodynamically unstable patients. Br J Anaesth. 2008;100:451\u2013456."},{"key":"i0003-3006-65-3-192-b24","series-title":"J Cardiothorac Vasc Anesth","first-page":"636","article-title":"Uncalibrated arterial pulse contour analysis versus continuous thermodilution technique: effect of alterations in arterial waveform","volume":"21","author":"Lorsomradee \n              S,","year":"2007","unstructured":"Lorsomradee \n              S, \n            \n            \n              Cromheecke \n              S, \n            \n            \n              De Hert \n              SG. \n            \n          \n          Uncalibrated arterial pulse contour analysis versus continuous thermodilution technique: effect of alterations in arterial waveform. J Cardiothorac Vasc Anesth. 2007;21:636\u2013643."},{"key":"i0003-3006-65-3-192-b25","series-title":"Intensive Care Med","first-page":"344","article-title":"A pilot assessment of the Flotrac cardiac output monitoring system","volume":"33","author":"Opdam \n              HI,","year":"2007","unstructured":"Opdam \n              HI, \n            \n            \n              Wan \n              L, \n            \n            \n              Bellomo \n              R. \n            \n          \n          A pilot assessment of the Flotrac cardiac output monitoring system. 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