Jackson Chase, Ikram Jibran, Diz Ferre Jose L, Ayad Sabry
Outcomes Research Consortium, Anesthesiology Department Cleveland Clinic Cleveland Ohio USA.
Clin Case Rep. 2025 Apr 21;13(4):e70454. doi: 10.1002/ccr3.70454. eCollection 2025 Apr.
Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) and Left Ventricular Non-Compaction Cardiomyopathy (LVNC) are inherited disorders that pose significant challenges in the obstetric population due to the potential exacerbation of ventricular arrhythmias and potentially lethal cardiac compromise during pregnancy and labor. This case report aims to provide insights into the anesthetic management of CPVT and LVNC in obstetric patients. Goals of management should include careful optimization of anesthesia and analgesia, particularly during the birthing process. The choice of anesthetic agents, particularly the avoidance of sympathomimetic drugs, is crucial in preventing catecholamine-induced arrhythmias. Additionally, the utilization of regional anesthesia techniques, such as epidural analgesia, may offer benefits in mitigating sympathetic activation during labor while providing adequate pain relief. Close collaboration between obstetricians, anesthesiologists, and cardiologists is imperative to develop a comprehensive management plan tailored to the individual patient's needs.
儿茶酚胺能多形性室性心动过速(CPVT)和左心室心肌致密化不全(LVNC)是遗传性疾病,在产科人群中构成重大挑战,因为在妊娠和分娩期间,室性心律失常可能会加重,并有潜在致命的心脏损害。本病例报告旨在深入探讨产科患者CPVT和LVNC的麻醉管理。管理目标应包括仔细优化麻醉和镇痛,尤其是在分娩过程中。麻醉药物的选择,特别是避免使用拟交感神经药物,对于预防儿茶酚胺诱发的心律失常至关重要。此外,使用区域麻醉技术,如硬膜外镇痛,可能有助于减轻分娩期间的交感神经激活,同时提供充分的疼痛缓解。产科医生、麻醉医生和心脏病专家之间密切合作对于制定针对个体患者需求的全面管理计划至关重要。