Anesthetic Management of a 70 Year old male with Advanced Hypopharyngeal Carcinoma and Triple-Vessel Coronary Artery Disease Undergoing Emergency Cystoscopy with Bladder Clot Evacuation
Abstract
Geriatric patients with advanced malignancy and severe comorbidities present major perioperative challenges. We report the anesthetic management of a 70-year-old man with advanced hypopharyngeal carcinoma, triple-vessel coronary artery disease (EF 30%), and renal failure requiring urgent endoscopy for gross hematuria. Preoperative evaluation revealed creatinine 5.1 mg/dL, uremic encephalopathy, and a difficult airway due to vocal cord fixation and facial palsy. Management prioritized hemodynamic stability using etomidate induction and specific airway strategies, ensuring an uneventful procedure. This case highlights the value of multidisciplinary planning to ensure myocardial protection and airway safety in high-risk oncologic patients.
[1] Kristensen SD, Knuuti J, Saraste A, Anker S, Bøtker HE, Hert SD, et al. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J. 2014; 35(35):2383-431.
[2] Kashlan B, Kinno M, Syed M. Perioperative myocardial injury and infarction after noncardiac surgery: a review of pathophysiology, diagnosis, and management. Front Cardiovasc Med. 2024; 11:1323425.
[3] Landesberg G, Beattie WS, Mosseri M, Jaffe AS, Alpert JS. Perioperative myocardial infarction. Circulation. 2009; 119(22):2936-44.
[4] Mishra S, Bhatti P, Viswanath G, Sapra A. Anaesthesia management in a patient of carcinoma endometrium with myocardial infarction and triple vessel disease: a case report. J Cardiovasc Dis Res. 2023; 14(12):2519-24.
[5] Aggarwal S, Goyal VK, Chaturvedi SK, Mathur V, Baj B, Kumar A. A comparative study between propofol and etomidate in patients under general anesthesia. Braz J Anesthesiol. 2016; 66(3):237-41.
[6] Kartik RL, Jayaraman V. Perioperative anesthetic management of a patient with oral tongue carcinoma and triple vessel coronary artery disease: a case report. J Chem Health Risks. 2025; 15(4):3102-4.
[7] Choi SG, Oh JS, Myoung H, Seo MH. Bell's palsy after concomitant chemoradiotherapy: a case report and literature review. J Dent Anesth Pain Med. 2024; 24(2):129-35.
[2] Kashlan B, Kinno M, Syed M. Perioperative myocardial injury and infarction after noncardiac surgery: a review of pathophysiology, diagnosis, and management. Front Cardiovasc Med. 2024; 11:1323425.
[3] Landesberg G, Beattie WS, Mosseri M, Jaffe AS, Alpert JS. Perioperative myocardial infarction. Circulation. 2009; 119(22):2936-44.
[4] Mishra S, Bhatti P, Viswanath G, Sapra A. Anaesthesia management in a patient of carcinoma endometrium with myocardial infarction and triple vessel disease: a case report. J Cardiovasc Dis Res. 2023; 14(12):2519-24.
[5] Aggarwal S, Goyal VK, Chaturvedi SK, Mathur V, Baj B, Kumar A. A comparative study between propofol and etomidate in patients under general anesthesia. Braz J Anesthesiol. 2016; 66(3):237-41.
[6] Kartik RL, Jayaraman V. Perioperative anesthetic management of a patient with oral tongue carcinoma and triple vessel coronary artery disease: a case report. J Chem Health Risks. 2025; 15(4):3102-4.
[7] Choi SG, Oh JS, Myoung H, Seo MH. Bell's palsy after concomitant chemoradiotherapy: a case report and literature review. J Dent Anesth Pain Med. 2024; 24(2):129-35.
| Files | ||
| Issue | Article in Press |
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| Section | Case Report(s) | |
| Keywords | ||
| Hypopharyngeal carcinoma Triple-vessel disease Difficult airway Geriatric anesthesia | ||
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How to Cite
1.
Kore S, Hunashikatti A. Anesthetic Management of a 70 Year old male with Advanced Hypopharyngeal Carcinoma and Triple-Vessel Coronary Artery Disease Undergoing Emergency Cystoscopy with Bladder Clot Evacuation. Arch Anesth & Crit Care. 2026;.
