Non Cardiac Surgery in a patient with Triple Vessel Disease and LBBB - Case Report

Abstract

Anaesthetising a patient with severe coronary artery disease for non-cardiac surgery especially one who has not undergone any revascularization in the form of angioplasty or coronary artery bypass grafting is very challenging. Preoperative risk stratification, optimisation, judicious selection of anaesthesia technique, perioperative management of pain and intravascular volume status are crucial factors in avoiding adverse outcomes in such patients. We describe successful anaesthesia management of a patient with triple vessel disease recommended for CABG, who underwent per-anal excision of a rectal adenoma under regional anaesthesia. We?ve also discussed the ECG criteria for diagnosis of LBBB and the diagnosis of myocardial infarction in presence of LBBB as the intrinsic rhythm.

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