The Effect of General Anesthesia and Mechanical Ventilation on the Echocardiographic Evaluation of Cardiac Function

Echocardiography is a cornerstone of diagnosis and management of heart disease. Its ability to provide real-time, detailed images of cardiac anatomy and function is essential for guiding both surgical and percutaneous cardiac interventions, the majority of which require the use of general anesthesia. The profound cardiac physiological changes that accompany general anesthesia can affect echocardiographic parameters and thereby potentially hamper accurate assessment. Next to anesthesia, mechanical ventilation also introduces hemodynamic changes in atrial, ventricular, and valvular function that further complicate echocardiographic interpretation. Of particular concern are changes in valvular regurgitant flow patterns and transvalvular gradients, which are critical for correct clinical diagnosis and treatment. Understanding the nuanced effects of anesthesia and mechanical ventilation on echocardiographic parameters is paramount for clinicians involved in cardiac care, including cardiologists, echocardiographers, anesthesiologists, intensivists and cardiac surgeons. Appropriate echocardiographic assessment under these conditions not only ensures accurate diagnosis, but also informs therapeutic strategies and guides intraoperative decision making and procedural planning. This narrative review highlights the complex interplay between general anesthesia, mechanical ventilation, and echocardiographic evaluation. By elucidating the physiological changes induced by these interventions, it aims to enhance clinical understanding and ultimately improve patient outcomes.