Anesthetic management of ischemic heart disease with ejectionfraction of 35% in a patient of fracture neck femur

Anesthetic management of cardiac patients coming for noncardiac surgery has always beenchallenging. Goal of anesthesia management is to keep myocardial oxygen supply greater than demand to avoid ischemia. In this case report, anesthetic implications included assessment of cardiovascular status of the patient preoperatively with selection of epidural anesthesia (EA) and analgesia technique. Incremental doses of local anesthetic were given to maintain myocardial oxygen demand. To the best of our knowledge, there have been only few case reports on EA for ischemic heart disease patient coming for noncardiac surgery. Hence, we report a successful anesthetic management of a patient with ischemic heart disease postedfor fracture neck of femur under EA and analgesia.