Post-Hysterectomy Discomfort: Chest Tightness and Concerns

What are the discomforts experienced after a hysterectomy? Thank you?

This year, during a miscarriage surgery in obstetrics and gynecology, I discovered that I had an invasive placenta.
Due to significant bleeding, the surgery had to be halted, and some of the placenta remained.
A month later, it could not be expelled naturally and the placenta enlarged, which was very dangerous.
I underwent a hysterectomy at a major hospital.
Now, two months post-surgery, during my follow-up visit, the doctor said that the wound healing and everything else were fine, and I do not need to return for further check-ups.
However, in my daily life, I occasionally feel a tightness in the middle of my sternum.
I cannot pinpoint any pain, and it does not feel like pain.
When I tilt my head back at a greater angle, I also feel a slight tightness.
There is no pain when swallowing or breathing, so it should not be related to the esophagus or trachea.
I have no other medical history, and neither does my family.
It does not seem to be worsening, but I am worried because it lingers; however, when I get busy, I do not notice it.
When I calm down, I tend to think more about the tightness.
During the surgery, there was no pressure on my chest, and this feeling of chest tightness is quite distressing.
I am concerned that something might be wrong.

Could you please advise me on what might be causing this condition? Which specialty should I consult? Thank you!

You Ning, 30~39 year old female. Ask Date: 2015/08/26

Dr. Lü Lizheng reply Obstetrics and Gynecology

The uterus is located in the lower abdomen.
After a hysterectomy, if there is discomfort, it is usually felt in the lower abdominal area.
If there is chest discomfort, priority should be given to considering issues related to the heart or lungs, and a consultation with a cardiologist or pulmonologist may be warranted.
Additionally, experiencing significant blood loss followed by a hysterectomy may leave one with unresolved anxiety, which can manifest as chest tightness.
Therefore, emotional adjustment should also be considered, and if necessary, a referral to a psychosomatic medicine specialist may be appropriate.
Sincerely, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/08/26

More Info

Post-hysterectomy discomfort, particularly the sensation of chest tightness, can be concerning for patients. In your case, it's understandable that after undergoing a significant surgical procedure like a hysterectomy, you might experience various sensations in your body, including the chest tightness you described.
Firstly, it’s important to recognize that the body undergoes many changes after major surgery, and these changes can sometimes manifest as discomfort or unusual sensations in areas that may not seem directly related to the surgical site. The chest tightness you are experiencing could be attributed to several factors:
1. Muscle Tension: After surgery, especially if you had a traumatic experience like a miscarriage with complications, it’s common for the body to hold tension. This can lead to muscle tightness in the chest area, which may feel like a tightness or pressure.

2. Anxiety and Stress: The emotional and psychological impact of undergoing a significant medical procedure can lead to anxiety, which often manifests physically. Anxiety can cause sensations of tightness in the chest, even if there is no underlying physical issue.

3. Postoperative Changes: After a hysterectomy, the body undergoes hormonal changes, especially if the ovaries were removed. These changes can sometimes lead to symptoms that may feel unusual, including sensations in the chest.

4. Gastroesophageal Reflux Disease (GERD): Sometimes, surgical procedures can affect the gastrointestinal tract, leading to issues like acid reflux, which can cause a sensation of tightness in the chest.

5. Cardiovascular Concerns: Although less likely given your description, it’s always prudent to rule out any cardiovascular issues, especially if you have risk factors or a family history of heart disease.

Given your symptoms, it would be advisable to consult with a healthcare professional. Here are some recommendations on which specialists to consider:
- Primary Care Physician: They can perform an initial assessment and determine if further evaluation is necessary.

- Cardiologist: If there are concerns about your heart, a cardiologist can conduct tests to rule out any cardiovascular issues.

- Gastroenterologist: If there is a suspicion of gastrointestinal issues, such as GERD, a gastroenterologist can provide appropriate evaluation and treatment.

- Psychologist or Counselor: If anxiety is suspected to be a contributing factor, speaking with a mental health professional can be beneficial.

In the meantime, consider keeping a journal of your symptoms, noting when they occur, their duration, and any associated activities or stressors. This information can be helpful for your healthcare provider in determining the cause of your discomfort.

Lastly, while it’s natural to feel concerned about new symptoms, it’s important to approach the situation with a balanced perspective. Many patients experience various sensations after surgery, and often these resolve with time. However, staying proactive about your health and seeking medical advice when needed is always the best course of action.

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