Graded Epidural Anaesthesia for Lower Segment Cesarean in a Parturient with Very Low Ejection Fraction.

Dilated cardiomyopathy is characterized by left or biventricular dilatation with impaired ventricular contractility. It is associated with systolic dysfunction with decreased left ventricular ejection fraction and congestive progressive heart failure. Anaesthetic management of such condition is very challenging and requires highest level of expertise, strategy and precaution. We present such a case of dilated cardiomyopathy with a very low ejection fraction of 12% who underwent lower segment cesarean section under epidural anaesthesia with successful outcome.