After a motor vehicle accident, a 57-year-old man with dilated cardiomyopathy has presented for open reduction and internal fixation of tibial fracture. History: alcohol abuse, orthopnea, dyspnea on exertion, and several episodes of pulmonary edema. Previous medication: digoxin, furosemide, and captopril. Physical examination: Bibasilar rales and an S3 gallop A gated blood pool scan showed a left ventricular ejection fraction of 15%.
Cardiac catheterization indicated a left ventricular end-diastolic pressure of 25 mmHg, a cardiac index of 1.8 L/min/m2 , 2+ mitral regurgitation, and no coronary artery disease. Which anesthetic agents would you prefer in this case? *This case is from Docplexus Editorial Team for educative purpose only.
