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Cardiac Complications for Postoperative Patients

The fear of something going wrong during surgery can be faced with eyes wide open, as clinical predictors are available to determine whether risks are prominent. As researchers have observed heart complications during and after non-cardiac surgery, they've realized that distinct risk factors and prevention exists.

  1. Cardiac Complications in Non-Cardiac Surgery

    • Since the heart is central to the operations of the body, negative outcomes of non-cardiac surgery have been observed to lead to complications such as nonfatal myocardial infarction [MI], pulmonary edema and ventricular tachycardia. The prevalence of cardiac complications hovers around 2 percent, a small percentage but one with serious implications.

    Types of Cardiac Complications

    • Nonfatal myocardial infarction is a heart attack that the patient is able to recover from, but still weakens the heart. Pulmonary edema, a result of heart failure, means that fluid pressure builds in the veins and in the lungs while increasing the difficulty of breathing. Ventricular tachycardia, a rapid, abnormal heartbeat resulting from heart dysfunction, can have consequences which range from discomfort to death.

    Classifying Risk

    • Assessing your risk for post-surgical complications can be accomplished by thinking through your current and past health status. If more than two of the following risk factors exist, an individual faces an exceptional chance that cardiac complications could occur.

    Important Pre-surgery questions

    • The type of surgery matters. If the surgery is being done inside the peritoneal or thoracic cavity---where the heart, lungs, and some blood vessels are---blood flow might be diminishedm or infection close to the heart could occur. If the patient has a history of heart disease, such as past heart attacks or consistent chest pain, surgery may be all it takes to trigger a serious attack. If the patient has been diagnosed with congestive heart failure, the heart has been unable at some point to pump enough blood to the body's organs. Past occurrences can indicate a serious underlying condition such as high blood pressure, heart valve disease, or dangerously narrow arteries which may all cause further heart congestion during surgery.

    Other pre-surgery considerations

    • When blood flow in the brain is interrupted by a blocked blood vessel, a stroke may occur. If a stroke has occurred in the past, add another risk point for post-surgery complications. If the patient lives with insulin-dependent diabetes, it may be reason for hesitation. Uncontrolled insulin-dependent diabetes raises the risk of cardiac complications after surgery, though the American Dietetic Association reports that properly controlled blood glucose levels can result in a 17 percent reduction in the risk of nonfatal myocardial infarctions. Another preventative step is to check creatine levels. Levels of > 2.0 mg/dL before surgery indicate ongoing kidney dysfunction. According to researchers, seeing signs of kidney dysfunction means poor long term outcomes during any kind of vascular surgery that might be enough reason to avoid surgery if possible.

    Reducing Risk

    • When risk is high, non-surgical alternatives such as lifestyle or diet changes might be preferable. When surgery is unavoidable, measures should be taken to improve the outcome. Researchers from the Boston University School of Public Health found that administering the B vitamin folate is associated with a decreased risk of infarction, acting as a natural preventative mechanism. Keeping blood pressure at its lowest by keeping sodium intake and stress levels at a minimum, will encourage the heart to work at its maximum efficiency, helping to keep cardiac complications at bay.

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