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Hypertrophic cardiomyopathy and the potential influence of etomidate on postoperative outcomes
  1. Ashsish Khanna1,
  2. Ashwat Dhillon2,
  3. Milind Y Desai2
  1. 1 Department of Anaesthesiology, Cleveland Clinic, Cleveland, Ohio, USA
  2. 2 Department of Cardiovascular Medicine Cleveland Clinic, Cleveland, Ohio, USA
  1. Correspondence to Dr Milind Y Desai, Cleveland Clinic, Cleveland, OH 44195, USA; desaim2{at}ccf.org

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We thank Dr White1 ,2 and colleagues for their insightful comments. The use of etomidate in a significantly greater proportion of patients with hypertrophic cardiomyopathy (HCM) versus non-HCM patients for induction of anaesthesia has been highlighted. A closer inspection of this issue brings forth the following pertinent points:

We agree with the higher use of etomidate in the HCM group. Within the limitations of a retrospective chart review, it seems fairly obvious that a higher proportion of anaesthesiologists chose etomidate as an induction agent as soon as they knew that their patient had HCM. This choice of etomidate as an induction agent seems obvious and the inherent haemodynamic …

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