Introduction: It is asymmetric hypertrophy of septum causing intermittent obstruction of left ventricular outflow tract. There is higher incidence of ischemia and sudden unexpected death due to acute left ventricular obstruction and fatal cardiac arrhythmias. Here we discuss a case of HOCM.

CASECAPSULE: A 22 yr old primi presented with shortness of breath on exertion from 4th month of her pregnancy. On evaluation 2D-echo revealed HOCM with severe left ventricular outflow tract obstruction with dynamic Mitral regurgitation with ejection fraction 60% and ECG showing left ventricular hypertrophy and T WAVE inversions in all chest leads. Patient is a known case of hypothyroid on T.Thyroxine 100ug and on T. Metoprolol 25mg.

Peri-op management of patient with HOCM possess significant challenge due to outflow tract obstruction that can we worsened by sympathetic stimulation or blockade. Here we report a case of primi with HOCM posted for elective caesarean section. She was successfully managed under general anaesthesia and delivered a healthy baby.

General anaesthetics can be safely given to a patient with HOCM with cautious use of anaesthetic drugs.