EN 
IN
Journal article
Operasi caesar dengan epidural anestesia pada pasien peripartum kardiomiopati dan hipotiroid
I Gusti Agung Bagus Kusuma Jayadi I Made Subagiartha
Volume : 50 Nomor : 2 Published : 2019, May
Medicina
Abstrak
The anesthesia principle management in patients with cardiovascular problems is to maintain hemodynamic stability and prevent hemodynamic turmoil that can cause deterioration in the patient’s condition. Peripartum cardiomyopathy (PPCM) is a condition of idiopathic cardiomyopathy associated with pregnancy. PPCM appears in the last month of pregnancy or 5 months after giving birth, without any history, risk factors or certain causes, which cause symptoms of heart failure. In this case report, there are patients with symptoms of heart failure that are felt suddenly in the final month of pregnancy. Patients complaint of severe shortness of breath that improves with a sitting position. This patient has no previous history of heart disease. There is no history of the same complain during the previous pregnancy. This is in accordance with the diagnostic criteria for PPCM where complaints occur in the last month of pregnancy, and patients have no history or risk of heart failure. Patients were also hypothyroid due to subtotal thyroidectomy 2 years ago. This can cause deterioration in the patient’s condition. Management of anesthesia in these patients is with neuraxial anesthesia, according to the literature mentioned, that the epidural block is performed. Epidural anesthesia is neuraxial anesthesia with segmental block type, in which a decrease in systemic vein resistance (SVR) occurs gradually so that it can maintain hemodynamic stability. Post-operatively, patients are treated in an intensive room for 3 days before being transferred to the intermediate room.