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Severe unprovoked hypertrophic obstructive cardiomyopathy: anaesthetic concerns in patient undergoing parathyroidectomy
  1. Asha Tyagi1,
  2. Chanchal Nigam1,
  3. Richa Pangtey1 and
  4. Vinayak Agrawal2
  1. 1Department of Anaesthesiology and Critical Care, University College of Medical Sciences, Dilshad Garden, Delhi, India
  2. 2Department of Clinical Cardiology, Fortis Memorial Research Institute, Gurgaon, Haryana, India
  1. Correspondence to Dr Asha Tyagi; drashatyagi{at}


This case highlights the role of an anaesthetist as a perioperative physician involved in diagnosing and optimising asymptomatic but severe hypertrophic obstructive cardiomyopathy. The modifications in anaesthetic technique for safe conduct of general anaesthesia during parathyroidectomy in a patient are also presented. These include those due to an extremely high left ventricular outflow tract obstruction with echocardiographic Doppler-derived maximum pressure gradient of 105 mm Hg at rest.

  • Anaesthesia
  • Calcium and bone
  • Head and neck surgery

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content—CN, AT, RP and VA. The following authors gave final approval of the manuscript—CN, AT, RP and VA.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.