Vol. 6 No. 3 (2026)
Open Access
Peer Reviewed

Anesthetic Management of Non-Cardiac Surgery in A Patient With Chemotherapy-Induced Cardiomyopathy and Severely Reduced Ejection Fraction: A Case Report

Authors

Dino Irawan , Mhd. Ayyub Rizki

Published:

2026-06-10

Abstract

Chemotherapy-induced cardiomyopathy is a serious complication of cancer therapy that can lead to a significant reduction in left ventricular ejection fraction and increase the risk of perioperative morbidity and mortality in non-cardiac surgery. This study aims to describe the anesthetic management of a patient with severe ventricular dysfunction secondary to chemotherapy undergoing non-cardiac surgery. This study used a descriptive observational design in the form of a single case report with retrospective data collection through medical record review, including preoperative evaluation, supporting examination results, intraoperative anesthetic strategies, hemodynamic parameters, use of vasoactive drugs, and postoperative outcomes. Data were analyzed descriptively by comparing clinical findings with relevant literature. The results showed that an individualized anesthetic approach, selection of agents with minimal myocardial depressant effects, careful fluid management, and strict hemodynamic monitoring were able to maintain perioperative stability without major cardiovascular complications. This report emphasizes the importance of a risk-based anesthetic strategy in improving patient safety in individuals with severely reduced ejection fraction due to chemotherapy-related cardiotoxicity.

Keywords:

chemotherapy-induced cardiomyopathy reduced ejection fraction anesthetic management non-cardiac surgery.

References

bedier, ahmed, teima, sally, El-Shamy, A. M., & elshal, abdallah. (2022). Clinical And Echocardiographic Predictors For Post-induction Hypotension During General Anesthesia. Zagazig University Medical Journal, 0. https://doi.org/10.21608/zumj.2022.136471.2562

Cao, H., Jiang, M., Zhuang, Z., Wang, S., & Cao, Q. (2024). Case report: Successful anesthesia management of noncardiac surgery in a patient with single atrium. Frontiers in Pharmacology, 15. https://doi.org/10.3389/fphar.2024.1370263

Cavaliere, F., Allegri, M., Apan, A., Brazzi, L., Carassiti, M., Cohen, E., Marco, P. D., Langeron, O., Rossi, M., Spieth, P., TURNBULL, D., & Weber, F. (2024). A year in review in Minerva Anestesiologica 2023: anesthesia, analgesia, and perioperative medicine. Minerva Anestesiologica, 90(3). https://doi.org/10.23736/s0375-9393.24.18067-4

Dabo-Trubelja, A., & Gottumukkala, V. (2023). Review of cancer therapies for the perioperative physician [Review of Review of cancer therapies for the perioperative physician]. Perioperative Medicine, 12(1). BioMed Central. https://doi.org/10.1186/s13741-023-00315-1

Dayani, A., Faritous, Z., Amniati, S., Bakhshande, H., Zamani, A., & Garekani, M. G. (2023). Anesthesia Management for the Patient with Chronic Decompensated Heart Failure and Low Cardiac Output Undergoing CABG with Advanced Cardiac Monitoring: A Case Report. Anesthesiology and Pain Medicine, 13(1). https://doi.org/10.5812/aapm-133796

Gupta, R., Gupta, N., Sirohiya, P., Pandit, A., Ratre, B. K., Vig, S., Bhan, S., Singh, R., Kumar, B., Bhopale, S., Mishra, S., Garg, R., Bharati, S. J., Kumar, V., Deo, S., & Bhatnagar, S. (2022). Perioperative anaesthetic management in cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC): a retrospective analysis in a single tertiary care cancer centre. Pleura and Peritoneum, 7(3), 127. https://doi.org/10.1515/pp-2022-0001

Laforteza, L. L., & Aspi, M. T. B. (2022). Use of a Combined Anaesthetic Technique and Minimally Invasive Hemodynamic Monitoring in a Primigravid with Uncorrected Tetralogy of Fallot for Caesarean Section. Acta Medica Philippina, 56(18). https://doi.org/10.47895/amp.v56i18.5653

Lee, C., Yumul, R., Vongchaichinsri, C., Tsai, K., & Wang, Y. (2022). Electrographic lead I and V5 monitoring could have detected a missed left-side pneumothorax intraoperatively. Research Square (Research Square). https://doi.org/10.21203/rs.3.rs-1934352/v1

Lian, L., Wang, Y., & Ning, X. (2022). A retrospective study from a single center of 252 patients who underwent elective pancreaticoduodenectomy to compare perioperative hemodynamic optimization therapy and usual protocols in terms of perioperative cardiac function. Experimental and Therapeutic Medicine, 24(5). https://doi.org/10.3892/etm.2022.11632

Mehmet, İ. G., Uğur, B. K., Çetin, F., Taşkum, İ., Cesur, M., Ganidağlı, S., & Uğur, M. G. (2024). Comparison of the effect of general anesthesia and combined epidural anesthesia on the anesthetic management of gynecological oncological surgery. Journal of Turkish Society of Obstetric and Gynecology, 21(4), 227. https://doi.org/10.4274/tjod.galenos.2024.22623

Nathan, N. (2024). Perioperative Hemodynamic Instability: The APSF Consensus. Anesthesia & Analgesia, 138(4), 712. https://doi.org/10.1213/ane.0000000000006944

Nitta, A., Sawada, A., Abe, K., Kamiyama, N., Takahashi, Y., Miyajima, M., Edanaga, M., & Yamakage, M. (2025). Perioperative management of thoracoscopic left cardiac sympathetic denervation for refractory long QT syndrome: a case report. JA Clinical Reports, 11(1). https://doi.org/10.1186/s40981-025-00815-7

Oshiba, Y., Shibata, S., Lee, T.-H., Inoue, J., & Kita, T. (2025). Early epidural analgesia for the preoperative management of suspected spontaneous pheochromocytoma rupture: a case report. JA Clinical Reports, 11(1). https://doi.org/10.1186/s40981-025-00813-9

Rayyan, M. I. R., Ghiffari, S. S., Hariyanto, A., Winarso, A. W. W., Darmawan, H., & Fardhani, I. M. (2024). Combined Spinal-Epidural Anesthesia with Isobaric Ropivacaine 0.375% for Inguinal Hernia Surgery in a Heart Failure Patient with Ejection Fraction of 36%. Indonesian Journal of Anesthesiology and Reanimation, 6(1), 50. https://doi.org/10.20473/ijar.v6i12024.50-57

Saugel, B., Bebert, E.-J., Briesenick, L., Hoppe, P., Greiwe, G., Yang, D., Ma, C., Mascha, E. J., Sessler, D. I., & Rogge, D. E. (2021). Mechanisms contributing to hypotension after anesthetic induction with sufentanil, propofol, and rocuronium: a prospective observational study. Journal of Clinical Monitoring and Computing, 36(2), 341. https://doi.org/10.1007/s10877-021-00653-9

Sharma, V., Aggarwal, H., Prakash, V., & Ahluwalia, P. (2023). Low Dose Combined Spinal-Epidural (CSE) Anaesthesia with Blocks for Management of A High-Risk Geriatric Patient with Dilated Cardiomyopathy Posted for TURBT. Journal of Anaesthesia and Critical Care Case Reports, 9(3), 2. https://doi.org/10.13107/jaccr.2023.v09.i03.221

Son, K., Tarao, K., Daimon, M., Yoshii, T., Nakagomi, A., & Hasegawa‐Moriyama, M. (2024). Preoperative echocardiography and anesthetic drugs as predictors of post-induction hypotension during general anesthesia: a prospective observational study. Scientific Reports, 14(1), 25717. https://doi.org/10.1038/s41598-024-76279-z

Thota, R. S., Seshadri, R., & Panigrahi, A. R. (2022). Combined fascial plane blocks as the sole regional anesthesia technique for breast surgery in high-risk patients. Journal of Anaesthesiology Clinical Pharmacology, 39(2), 312. https://doi.org/10.4103/joacp.joacp_265_21

Watson, J., Ninh, M. K., Ashford, S. A., Cornett, E. M., Kaye, A. D., Urits, I., & Viswanath, O. (2021). Anesthesia Medications and Interaction with Chemotherapeutic Agents [Review of Anesthesia Medications and Interaction with Chemotherapeutic Agents]. Oncology and Therapy, 9(1), 121. Adis, Springer Healthcare. https://doi.org/10.1007/s40487-021-00149-1

Zhang, N., Wang, T., Wei, P., Zhou, J., & Li, J. (2021). Ultrasound-Guided Regional Anesthesia Under Sedation for Radical Mastectomy in an SAS Patient: A Case Report. Frontiers in Oncology, 11. https://doi.org/10.3389/fonc.2021.631003

Author Biographies

Dino Irawan, Departement Anestesiologi dan Terapi Intensif FK UNRI/ RSUD Arifin Achmad

Author Origin : Indonesia

Mhd. Ayyub Rizki, Departement Anestesiologi dan Terapi Intensif FK UNRI/ RSUD Arifin Achmad

Author Origin : Indonesia

Downloads

Download data is not yet available.

How to Cite

Dino Irawan, & Mhd. Ayyub Rizki. (2026). Anesthetic Management of Non-Cardiac Surgery in A Patient With Chemotherapy-Induced Cardiomyopathy and Severely Reduced Ejection Fraction: A Case Report. International Journal of Educational Review, Law And Social Sciences (IJERLAS), 6(3). Retrieved from https://radjapublika.com/index.php/IJERLAS/article/view/5328

Similar Articles

<< < 6 7 8 9 10 11 12 13 14 15 > >> 

You may also start an advanced similarity search for this article.