Complications affecting the heart
Depending on the treatment, heart surgery can be performed on the beating or the standing heart. In those cases where the heart has to be stopped during the surgical procedure, there is a risk of special complications. During the heart surgery, the circulatory system must be driven by a heart-lung machine.
Only in this way can the supply of oxygen and nutrients to the vital organs be guaranteed. Although the procedures that are now standard practice are comparatively safe, postoperative complications can still occur after cardiac surgery using a heart-lung machine. In particular, the formation of blood clots, which can lead to a stroke or heart attack in the course of the operation, plays a decisive role in this context.
Other typical postoperative complications after cardiac surgery are based on the type of surgical intervention. In particular, the wound pain after heart surgery is experienced as very stressful by many of the patients affected. For this reason, targeted pain therapy should be initiated immediately after the heart surgery.
In this context, the principle applies that a patient may receive as many painkillers as he/she actually needs after a heart operation. Adequate pain relief has been proven to have a positive effect on the healing process. Furthermore, the temporary occurrence of pronounced fatigue and general weakness is one of the most frequent postoperative complications after extensive heart surgery.
This is due to the fact that heart surgery is a great strain on the organism, which can lead to physical and mental exhaustion. This possible post-operative complication can become problematic, especially for older and generally weakened patients. Even after a heart operation without complications, a recovery phase of several weeks should therefore be planned.
In addition, many patients report postoperative complications affecting memory after heart surgery. Concentration problems, memory gaps or confusion during heart surgery are mainly caused by the anesthesia and the changed circulatory conditions during the surgical procedure. In patients who already suffered from memory problems before the heart surgery, the symptoms can be aggravated for a few days.
Hallucinations are also among the typical postoperative complications after heart surgery. In addition, the initiation of general anesthesia can lead to an interruption of the day-night rhythm.This can lead to pronounced sleep disorders within the first few nights. Severe pain after heart surgery can intensify this phenomenon.
In addition, temporary visual disturbances are one of the most common postoperative complications after heart surgery. The visual disturbances occur in the affected patients within the first weeks after the surgical procedure and manifest themselves in the form of: blurred vision, flickering eyes and/or visual hallucinations. Depending on the type and severity of the heart disease that requires surgical treatment, postoperative cardiac arrhythmia may also occur.
One of the most common cardiac arrhythmias that occur as a postoperative complication after heart surgery is the so-called “atrial fibrillation“. This is manifested by an irregular, rapid pulse and palpitations. In most cases, this postoperative complication can be easily treated with medication.
However, some of the patients affected require electrical cardioversion, in which an electrical impulse is used to restore normal heart rhythm. The occurrence of fluid retention, so-called edema, is also one of the typical postoperative complications after heart surgery. In the patients affected, fluid is already being displaced into the tissue during the surgical procedure.
Clinically, this complication is recognized by a rapid weight gain and severe swelling in the area of the hands and feet. In many cases the excess fluid is excreted within the first postoperative days without medical intervention. If this is not the case, a diuretic therapy must often be initiated.
Acute cardiovascular failure is accompanied by a sudden drop in blood pressure. Clinically, patients become pale and the skin turns bluish, arms and legs become cold as the blood supply is limited to the most important organs. Causes of such failure are a significantly too high heart rate, shortness of breath, shallow rapid breathing and pulmonary edema.
The therapy consists of sufficient oxygenation, if necessary ventilation, venous access and slow volume delivery. In addition, patients must be monitored by intensive care medicine. A derailed heart failure is the result of acute pumping failure of the heart due to, for example, a heart attack, pulmonary embolism or various cardiac dysrhythmias. Clinically, the patients suffer from shortness of breath, significantly increased heart and respiratory rate, but this leads to ineffective oxygen uptake and oxygen transport. The therapy consists of elevating the upper body, lowering the volume, oxygen administration and drug treatment of the high heart rate.
