Case Report
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World J Anesthesiol. Mar 27, 2013; 2(1): 8-10
Published online Mar 27, 2013. doi: 10.5313/wja.v2.i1.8
Anesthetic management of patient with hypertrophic cardiomyopathy and automatic implantable cardioverter defibrillator with a hand fracture
Jaime Ortiz
Jaime Ortiz, Department of Anesthesiology, Baylor College of Medicine, Houston, TX 77025, United States
Author contributions: Ortiz J participated in the case and wrote entire manuscript.
Correspondence to: Jaime Ortiz, MD, Department of Anesthesiology, Baylor College of Medicine, 1709 Dryden Way, Suite 1700, Houston, TX 77025, United States. jaimeo@bcm.edu
Telephone: +1-713-8732860 Fax: +1-713-8732867
Received: February 17, 2013
Revised: March 20, 2013
Accepted: March 25, 2013
Published online: March 27, 2013
Processing time: 81 Days and 3.1 Hours
Abstract

A 26-year-old male with a history of hypertrophic cardiomyopathy (HCM) and ventricular arrhythmias s/p automatic implantable cardioverter defibrillator (AICD) placement presented for open reduction and internal fixation of an open third metacarpal fracture and extensor tendon repair. He underwent successful surgery after placement of an ultrasound-guided infraclavicular brachial plexus block with ropivacaine 0.5% as the main anesthetic. This case report discusses the anesthetic management of patients with HCM and AICD, different approaches available for brachial plexus blockade, and potential complications of anesthesia and surgery in this group of patients.

Keywords: Hypertrophic cardiomyopathy; Automatic implantable cardioverter defibrillator; Brachial plexus block; Hand fracture; Ropivacaine

Core tip: The anesthetic management of patients with hypertrophic cardiomyopathy (HCM) and automatic implantable cardioverter defibrillator (AICD) can be very challenging. We present a case of a 26-year-old male who presented for open reduction and internal fixation of an open right hand fracture. He underwent successful surgery after placement of an ultrasound-guided infraclavicular brachial plexus block with ropivacaine 0.5% as the main anesthetic.