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Effects of Anesthesia on the Heart

Anesthesia has become remarkably safe in the last several decades. Nevertheless, certain medical conditions require extra care by a qualified professional when a patient undergoes anesthesia. Training for anesthesia practitioners includes education in the proper selection of anesthetic gases, medicines and monitoring techniques to care for patients with even the most serious underlying medical problems. A patient undergoing anesthesia must provide her anesthesiologist with a complete medical history, including any and all substances, herbal supplements and medicines used, to ensure her safety.

  1. Misconceptions

    • The media frequently report prominent cases of death under anesthesia as a person's "heart stopped" under anesthesia. This is an oversimplification. These cases frequently involve unpredictable reactions to medications, failure to successfully provide oxygen and breathe for a patient (something done by anesthesiologists every day) or failure to appreciate and appropriately manage a patient's significant underlying illnesses (severe lung or heart disease, for example). That's why a complete and honest medical history is vital.

    Direct Effects

    • Several anesthetic agents have a direct effect on the heart. Anesthetic gases decrease the pumping ability of the heart. For those with poorly functioning hearts, that effect can be very dangerous. Local anesthetics have the potential to bring on a disordered heart rhythm. Anesthetic medicines used to induce unconsciousness can also decrease the pumping ability of the heart.

    Assessing Risk

    • Patients with certain heart conditions may get tests ranging from a quick physical by a cardiologist to an electrocardiogram (EKG) to an echocardiogram or even a stress test. The anesthesiologist reviews the results of the test, then speaks to the patient before the surgery to take a medical history and perform a physical exam. The anesthesiologist uses all of this information to formulate a plan for the anesthetic delivery.

    Implications

    • People with decreased heart function (congestive heart failure, multiple past heart attacks, heart rhythm disorders/pacemakers) may require additional or special monitoring and selection of different anesthetics and medications to usher them safely through surgery. Patients with severe COPD (chronic obstructive pulmonary disease) or severe sleep apnea may require special means to provide oxygen effectively.

    Prevention/Solution

    • Anesthesiologists choose drugs and agents carefully, taking into account a person's medical history, and may choose additional monitoring techniques to ensure the patient's safety. In addition, several medicines are available to treat some of these heart-related side effects should they occur. Be sure to talk with your surgeon about your concerns, and when the time comes provide your anesthesiologist with a complete history.

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