Post-Surgery Heart Concerns: Risks and Recovery

Postoperative cardiac issues?

Hello, Director: The issue is a bit lengthy: In 2006, I was diagnosed with mild mitral valve prolapse, but the doctor said no medication was needed, so I did not see a doctor again.
In 2017, after giving birth, I developed hyperthyroidism, which caused my heart rate to fluctuate around 140 beats per minute.
I consulted an endocrinologist and started medication to manage the hyperthyroidism, and my levels are now normal with a heart rate below 100.
However, on November 5, 2018, I underwent an open inguinal hernia repair surgery under general anesthesia, and a risk assessment was performed, which indicated a level 2 risk.
The endocrinologist also stated that my hyperthyroidism was well-controlled and there were no issues with proceeding with the surgery, so the operation took place on November 5.

During recovery in the post-anesthesia care unit, my heart rate suddenly increased to 180 beats per minute.
I was terrified and felt short of breath, with some tingling in my fingers.
I was concerned about the possibility of an anesthetic storm or a hyperthyroid storm.
The anesthesiologist quickly came to reassure me and administered two injections, which I am unsure of the contents, and my heart rate gradually decreased to the 120s.
Later, the doctor mentioned that I was hyperventilating due to anxiety.
Shortly after, I was transferred back to my hospital room, and my heart rate slowly returned to the 80s and below 100.

I have since been discharged, but during my hospital stay, I requested another electrocardiogram, but the doctor felt it was unnecessary.
I would like to ask if I should get my heart checked.
I am deeply afraid of an anesthetic storm, and although I am now home, I still feel anxious.
Is this a heart problem?

Xin, 40~49 year old female. Ask Date: 2018/11/11

Dr. He Dongjin reply Cardiology

Hello, it seems that the excessive hyperventilation is caused by panic disorder, which does not appear to be related to heart issues, anesthetic storm, or thyroid storm.
It is advisable to observe the situation for now.
Changhua Hospital cares about you.

Reply Date: 2018/11/11

More Info

Post-surgery heart concerns can be quite daunting, especially when there are underlying conditions such as mitral valve prolapse and hyperthyroidism. Your experience during and after the hernia surgery, particularly the episodes of tachycardia (rapid heartbeat), can understandably lead to anxiety about your heart health.
Firstly, it is important to recognize that episodes of increased heart rate can occur in response to various factors, including anxiety, pain, and the physiological stress of surgery. In your case, the rapid heart rate you experienced (up to 180 beats per minute) could have been a response to the stress of surgery, the effects of anesthesia, or even anxiety about the procedure itself. The fact that your heart rate stabilized after medical intervention is a positive sign, indicating that your heart was able to recover from the acute stress.

Given your history of mitral valve prolapse, it is wise to remain vigilant about your heart health. While many individuals with mitral valve prolapse lead normal, healthy lives without significant complications, it is essential to monitor for any changes, especially after experiencing symptoms like tachycardia.
In terms of follow-up care, it would be prudent to consult with a cardiologist, particularly since you have experienced significant heart rate fluctuations. A thorough evaluation may include an electrocardiogram (ECG) to assess your heart's rhythm and function, and possibly an echocardiogram to evaluate the structure and function of your heart valves. These tests can provide reassurance and help identify any potential issues that may need to be addressed.

Additionally, considering your history of hyperthyroidism, it is crucial to ensure that your thyroid levels remain stable, as fluctuations in thyroid hormone levels can significantly impact heart rate and overall cardiovascular health. Regular follow-ups with your endocrinologist to monitor your thyroid function are essential.

Regarding your concerns about "anesthesia storm" or "thyroid storm," it is important to understand that these are serious but rare complications. Anesthesia storm refers to severe reactions to anesthesia, while thyroid storm is a life-threatening condition that can occur in individuals with untreated hyperthyroidism. Since your hyperthyroidism is currently well-managed, the risk of a thyroid storm should be low, but it is still important to maintain regular check-ups to ensure your thyroid levels remain stable.

In summary, while your experience during surgery was concerning, it does not necessarily indicate a chronic heart problem. However, given your medical history and the symptoms you experienced, it is advisable to seek a cardiology consultation for a comprehensive evaluation. This will not only help in addressing your current concerns but also provide peace of mind as you continue your recovery. Remember, proactive management of your health is key, and regular check-ups can help catch any potential issues early on.

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