# Perioperative Implications in a Hypertrophic Cardiomyopathy Patient Undergoing Endonasal Orbital Decompression: A Case Report

## TL;DR

This case report details the successful management of a patient with thyroid eye disease and hypertrophic cardiomyopathy undergoing orbital decompression surgery.

## Contribution

The paper highlights effective perioperative strategies for managing non-cardiac surgery in patients with HCM and hyperthyroidism.

## Key findings

- Detailed preoperative evaluation is crucial for managing HCM patients undergoing non-cardiac surgery.
- Vigilant intraoperative monitoring and adequate analgesia can ensure a smooth perioperative course.
- Successful outcomes are achievable with careful management in HCM patients with TED.

## Abstract

Thyroid eye disease (TED) is an autoimmune disease of the retro-ocular tissue and occurs in patients with Graves’ disease with hyperthyroidism. In severe cases, it can lead to vision loss; hence, timely management is important. Hypertrophic cardiomyopathy (HCM) is one of the systemic manifestations related to hyperthyroidism. We present a case of successful perioperative management of Graves’ disease with TED and HCM posted for endonasal decompression surgery. Hyperthyroidism itself has many implications on perioperative anesthetic management, which can become more complicated when associated with co-existing HCM. However, our case proves that detailed preoperative evaluation, vigilant intraoperative monitoring, and adequate analgesia can lead to a smooth perioperative course for HCM patients for non-cardiac surgeries.