Anaesthetic management of a patient with dilated cardiomyopathy posted for non-cardiac surgery

Dilated cardiomyopathy (DCM) is characterized by impaired ventricular contractility and causes concern in anaesthetic management as it may sometimes predispose to malignant arrhythmias. A 77-year-old woman diagnosed to have irreducible umbilical hernia, was posted for emergency laparotomy and hernia repair. On examination, she belonged to American Society of Anesthesiologists (ASA) physical status grade III with a functional status of 4 metabolic equivalents (METs). She was also suffering from DCM with severe left ventricular (LV) dysfunction (LV ejection fraction 25%). This patient was successfully managed by administering general anaesthesia with ProSeal laryngeal mask airway. We report the detailed anaesthetic management of this patient who underwent emergency laparotomy and hernia repair.