Anesthetic management of a patient with dilated cardiomyopathy and end stage renal disease

Cardiovascular disease is the leading cause of mortality among patients with end stage kidney disease (ESKD). Left ventricular hypertrophy (LVH) and left ventricular dilation (LVD) are independent risk factors for mortality and make the management of a patient with dilated cardiomyopathy (DCM) and ESKD stage 5. undergoing noncardiac surgery is a real challenging task as the perioperative course may be complicated by cardiac arrhythmias or cardiac failure at any time and associated with high perioperative morbidity and mortality. An adequate knowledge of the pathophysiology of these diseases and treatment modalities is essential to manage these cases successfully. Meticulous planning is the key to success. We stress that adequate preoperative preparation and a planned anesthesia leads to a successful management of dilated cardiomyopathy with ESKD.