Open AccessErroneous blood pressure readings in a patient with Multiple Hereditary Exostoses
Author(s) -
Stein Mark,
Mungekar Sagar S.
Publication year - 2013
Publication title -
anaesthesia cases
Language(s) - English
Resource type - Journals
ISSN - 2396-8397
DOI - 10.1002/j.2396-8397.2013.tb00002.x
Subject(s) - medicine , blood pressure , cuff , hereditary multiple exostoses , oxygen saturation , anesthesia , surgery , anatomy , osteochondroma , oxygen , chemistry , organic chemistry
Summary A 15 year old male with Multiple Hereditary Exostoses (MHE) developed what appeared to be profound hypotension shortly after induction of anaesthesia. All other clinical parameters, including skin color, breath sounds, heart rate, peripheral pulses, oxygen saturation and end‐tidal carbon dioxide were normal. When the cuff of the automated blood pressure device was removed and reapplied elsewhere, the blood pressure reading was normal. Examination of the original location of the cuff revealed an exostosis on the medial aspect of the proximal humerus, which had prevented the automated blood pressure device from detecting the pulsation of the artery. Had a preoperative examination of the limb been done, it may have resulted in using a different location for blood pressure monitoring, and prevented the erroneous readings. Additional issues of concern to the anaesthetist in patients with Multiple Hereditary Exostoses are discussed.