Diastolic dysfunction complicating anesthetic management.

Coronary artery disease combined with constrictive pericarditis results in diastolic dysfunction with a well-preserved systolic function. A case of constrictive pericarditis with a restrictive filling pattern and a well-established preoperative diastolic dysfunction, that had an elective pericardiectomy and an off pump coronary artery by pass graft, is discussed. Once revascularization was performed, introduction of Inj. nitroglycerine resulted in a dramatic improvement in the hemodynamics, along with a drop in the intra chamber filling pressures, indicating an improvement in the diastolic function. The role of revascularization and vasodilators as therapeutic tools in the management of diastolic dysfunction in such cases, is highlighted.