Anaesthesia for Patients with Pericardial Disease

Abstract

Patients with pericardial disease can present to the anaesthesiologist for a variety of diagnostic procedures or therapeutic interventions. Providing safe anaesthesia care for these patients is challenging because of their primary pericardial pathology and significant co-morbidities affecting other organ systems. A thorough understanding of the pathophysiology of the pericardial disease state and its effect on overall haemodynamic variables is necessary before formulating a perioperative care plan. A multidisciplinary approach involving cardiology, surgical, anaesthesia and critical care teams is needed to provide optimal peri-operative care. This chapter examines the basic pathophysiology of pericarditis, pericardial effusions, tamponade and constrictive pericarditis as these conditions pertain to the anaesthesiologist in the peri-operative period. Diagnostic tools, especially the role of echocardiography, that aid in the diagnosis and management of these high-risk patients are highlighted.

Manejo anestésico en paciente obstétrica con taponamiento cardíaco

“…El uso de la ecocardiografía transtorácica es el Gold estándar para la detección de taponamiento cardíaco, por tener alta sensibilidad y especificidad 6 , ya que permite la evaluación del miocardio con la medición del tamaño de la cámara cardiaca en las diferentes etapas del embarazo y en el puerperio 7 .…”

Ultrasound-guided serratus plane block combined with intercostal block for a high-risk patient with pericardial tamponade: A case report

“…The etiology of pericardial tamponade is highly varied, with trauma, malignancy, end-stage renal disease, iatrogenic, and idiopathic as the most common causes. [ 1 2 3 ]…”

“…Surgical drainage can be achieved by the creation of a subxiphoid pericardial window, or a small anterior thoracotomy using either an open or a thoracoscopic approach, or by the creation of a pericardial–peritoneal window. [ 1 2 3 ]…”

Anaesthetic management in a dog with constrictive pericarditis complicated with bi‐atrial enlargement and atrial fibrillation undergoing subtotal pericardiectomy

“…1,2 End-diastolic ventricular filling can be severely impaired and the total blood volume within the heart remains relative constant, which leads to a fixed stroke volume state. 3 CP is not common in dogs and cats and its aetiology in most of the cases remains unclear (idiopathic). [1][2][3][4][5] Clinical presentation of CP can be non-specific and clinical signs are similar to those seen in right-sided congestive heart failure (CHF).…”