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- W4246994076 abstract "Editor—It was interesting to read Staikou and colleagues’1Staikou C Chondrogiannis K Mani A Perioperative management of hereditary arrhythmogenic syndromes.Br J Anaesth. 2012; 108: 730-744doi:10.1093/bja/aes105Abstract Full Text Full Text PDF PubMed Scopus (45) Google Scholar excellent review of Perioperative management of hereditary arrhythmogenic syndromes. This group of disorders seems to have previously been under represented in mainstream anaesthetic literature. The collective incidence of the group of disorders that are described means that all consultant anaesthetists will have anaesthetized a number of patients who will subsequently present with one of these disorders. The fact that presentation is often with sudden death raises obvious questions as to whether a number of these deaths could be prevented by earlier identification. The majority of those presenting for anaesthesia with such an underlying condition are likely to arrive with no confirmed diagnosis. Diagnosis of these conditions may be difficult as a large number of genotypes can result in different ion channel or other structural abnormalities that result in similar phenotypic variations, which may be characterized under one diagnosis. Variable penetrance and the fact that presentation of these congenital abnormalities is often not before adolescence, or later in life, makes the identification of familial patterns difficult. Traditional teaching has been that ventricular extrasystoles are not uncommon in middle age and in patients with no ischaemic heart disease or obvious cardiomyopathy are usually of no clinical significance. Similarly, occasional short runs of bigemeni noted on ECG monitors are often assumed to be benign if they resolve spontaneously and do not result in any detectable short-term consequences. Anaesthetists watching ECGs for extended periods of time during otherwise uneventful cases are ideally placed to identify and highlight certain individuals for investigation. Is it now time for anaesthetists to have a higher index of suspicion when they observe frequent signs of ventricular ectopy that do not result in short-term detrimental effects? A postoperative discussion to elicit any family history of unexplained or early cardiac death, 24 h ECG monitoring, and an echocardiogram would seem to be appropriate steps to take in any patient showing abnormal ectopy. The challenge now, in an era of finite resources, must be to define the level at which to act. None declared." @default.
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- W4246994076 date "2012-10-01" @default.
- W4246994076 modified "2023-10-18" @default.
- W4246994076 title "Inherited cardiomyopathies" @default.
- W4246994076 cites W2130475966 @default.
- W4246994076 doi "https://doi.org/10.1093/bja/aes327" @default.
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