**10. Conclusion**

**8.2. Management**

122 Current Topics in Intensive Care Medicine

highly effective.

**8.3. Anaesthetic management**

Optimal therapy is yet to be defined [9]. Beta blockers, diuretics, and ACE inhibitor and vasodilators have been used. Adrenergic agonists and antiadrenergic therapy (beta adrenergic

A principle anaesthetic goal is to avoid psychological and physical stress that could trigger acute cardiomyopathy in susceptible patients. Thorough patient counselling, effective premedication and preoperative beta blocker therapy before transfer to operating room are

Laryngoscopy, intubation, extubation, emergence, and inadequate postoperative pain control may cause a sympathetic response and increase catecholamine levels, so an optimal anaesthesia/analgesia is required in these phases. It is suggested that regional anaesthesia may be

It is unclear whether administration of inotropic drugs to treat systolic dysfunction is harmful. Inotrope of choice remains unclear, though Milrinone, aphosphodiesterase inhibitor, and a calcium sensitizer, levosimendan are suggested. Mechanical support of circulation with IABP or LVAD is an option to tide over periods of crisis. Beta blocker therapy may not be haemodynamically tolerated or could be potentially hazardous. Beta agonists should be avoided or used carefully, vasopressors may be used and supportive treatment for CHF should be instituted. LV dysfunction resolves within 2–4 weeks. Most cases recover spontaneously with

When a person is admitted with a diagnosis of cardiomyopathy, the main aims of therapy whether in the intensive care or coronary care unit are, to reduce the workload of the heart and to improve the pumping ability of the heart. This can be achieved with the help of drugs such as inotropes, diuretics, ACE inhibitors, beta blockers, calcium channel blockers, and so on, which aids in improving the pumping action of the heart muscle and treatment to ensure

Treatment of the patients in the intensive care unit depends not only on the type and the severity of cardiomyopathy but also condition of patient. Treatment may include conservative management with drugs, implantation of pacemakers, defibrillators for those prone to fatal heart rhythms, ventricular assist devices or extracorporeal membrane oxygenators for severe heart failure, or ablation for recurring dysrhythmias that cannot be managed by drugs or cardioversion. The goal of management in the intensive care unit is often symptomatic, and

blockers or alpha 2 agonists) and QT prolonging medications are to be avoided.

beneficial, but adequate studies to support this theory are not available.

a mortality risk of 0–8%.Recurrence occurs in 2–5% cases [10].

**9. Intensive care unit management**

the proper volume of blood in the body.

some patients may eventually require a heart transplant.

Nowadays, cardiomyopathies are being identified increasingly as a result of improved means of detection with echocardiographic examination and an increase in the ageing population group. In addition, the presentation of this disease is varied. It may be sudden or already well known to the patient. Anaesthesia administration for patients with cardiomyopathy can lead to perioperative morbidity and mortality during elective or, more importantly in emergency surgeries. Therefore, anaesthesia and postoperative care have to be carefully titrated, planned, and monitored for every patient, for which we need a thorough understanding of the pathophysiology of cardiomyopathies. The best approach would be a multidisciplinary team that includes anaesthetists, cardiologists, and surgeons. As anaesthesiologists, we have to expand our horizon from operating room to ICU with a thorough understanding of non-invasive and invasive monitoring methods and a basic knowledge of transthoracic echocardiography.
