Unusual Pulsating Sensation in Chest After Heart Surgery: What to Know

After traditional open-heart surgery, a pulsating mass resembling a pulse was observed on the left side of the sternum?

My father underwent traditional open-heart surgery in December last year for mitral valve replacement and tricuspid valve ring repair.
Recently, he noticed a moving structure on the left side of his sternum (about two fingerbreadths below the nipple, though he is unsure how long it has been there).
It appears to be a blood vessel or vein that moves like a worm, approximately the width of a finger, and it has a pulsating sensation when touched.
He does not feel any discomfort, and pressing on it does not cause any unusual symptoms (such as shortness of breath or others).
What could this be? Is it concerning? Should he schedule an earlier follow-up appointment? Thank you.

elsa, 30~39 year old female. Ask Date: 2024/03/20

Dr. Wu Xueming reply Cardiology

Based on your description, I am unable to determine what it is.
I recommend that you visit the outpatient clinic for a detailed examination by the surgeon.

Reply Date: 2024/03/20

More Info

After heart surgery, particularly after procedures such as valve replacement or repair, it is not uncommon for patients to experience various sensations in the chest area. The unusual pulsating sensation your father is experiencing, described as a moving "blood vessel" or "vein" under the skin, can be concerning, but it is important to understand the context and potential causes.

Understanding the Pulsating Sensation
1. Post-Surgical Changes: After heart surgery, the body undergoes significant changes as it heals. The surgical manipulation of the heart and surrounding structures can lead to alterations in the way blood vessels and tissues behave. This can sometimes result in sensations that feel like pulsations or movements under the skin.

2. Vascular Changes: The sensation described could be related to the healing of blood vessels or the presence of a suture or graft that may be palpable. Sometimes, the movement of blood through a newly repaired or replaced valve can create a sensation that feels like a pulse in the chest wall.

3. Nerve Sensitivity: Surgery can also affect the nerves in the area, leading to heightened sensitivity or unusual sensations. This can manifest as a feeling of pulsation, even if there is no actual abnormality present.

4. Absence of Symptoms: The fact that your father is not experiencing any discomfort, shortness of breath, or other concerning symptoms is a positive sign. Typically, if there were a significant issue, such as a vascular complication or infection, other symptoms would likely accompany it.

When to Seek Medical Attention
While the absence of discomfort is reassuring, it is still important to monitor the situation. Here are some guidelines on when to seek medical attention:
- Persistent Changes: If the pulsating sensation persists or worsens over time, it would be wise to consult with a healthcare provider. Changes in the nature of the sensation or the development of new symptoms could warrant further investigation.

- New Symptoms: If your father begins to experience any new symptoms such as chest pain, shortness of breath, swelling, or changes in skin color over the area, he should seek medical attention promptly.

- Follow-Up Appointments: It is always a good practice to keep up with scheduled follow-up appointments after heart surgery. If there is any concern or uncertainty, it is advisable to bring this up during the next visit.

Conclusion
In summary, the unusual pulsating sensation your father is experiencing could be a normal part of the healing process after heart surgery. However, it is essential to remain vigilant and monitor for any changes or new symptoms. If there is any doubt or concern, it is always best to consult with a healthcare professional for personalized advice and reassurance. Regular follow-ups with the cardiologist or surgeon can help ensure that any potential issues are addressed promptly.

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