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One month post op and short of breath

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  • One month post op and short of breath

    I need some advice from other folks who have had there sternum cracked! I am one month post aortic valve replacement with a mechanical valve. Echo of the valve indicates it is functioning fine. Lungs are clear. However, I have palpatations (particularly when I stand up) and I have shortness of breath. The docs say it is normal; however, I am concerned. Any consumers out there have any input?


    Gregory Golden

  • #2
    Hi Greg,

    Sorry to hear that you are running into this. I don't recall that I had that condition after my surgery, but I was wondering if perhaps it may be caused by the new medication that you are taking since your surgery. Are you now on a Beta Blocker? If so, What dosage? You may want to ask your doctor if any of the meds you are on may be the culprit.

    Wishing you good health,

    3/23/00 Ascending Aortic Dissection-St. Judes mech valve+graft, Vanderbilt, Nashville, TN
    9/16/10 ON-X Aortic Valve/Root Replacment, Cleveland Clinic,OH, Dr Pettersson
    9/16/10 Aortic Stent and Frozen Elephant Trunk Procedure, Cleveland Clinic,OH, Dr. Roselli


    • #3
      Hi Greg
      I'm 2 1/2 months post op and still find I'm SOB on any exertion, yet prior to becoming ill last fall I had no such symptoms. I am attending a rehab program and they have me walking 1/2 hour per day at a brisk enough pace to get my heart rate to an "aerobic" level. I mentioned the shortness of breath problem to one of the nurses and she said surgery can leave iron levels low and lack of iron inhibits the lung's ability to provide oxygen. I checked and sure enough my oxygen levels are low. She recommended pre natal vitamins as they tend to be high in iron. However before I take them I want to be sure such a supplement won't interfere with my INR levels.
      Anyone else heard of this ???


      • #4

        I didn't notice those types symptoms 1 month out. Only thing I felt at that point was a little sternum soreness (I had quit taking all pain meds including tylonol) and occassional "pounding" (still feel now and then). I know it's hard to not be concerned even though the doc's don't seem to be.

        I do feel a whole lot better 9 weeks out, even starting to do cardio for as long as prior to surgery, just not quite at the same level quite yet. I even played with the weights a bit, still going to wait a couple more weeks before "lifting".

        Hopefully with a bit more time the SOB and palpatations will go away.

        Best wishes.


        Tom: The doc's suggested pre-natal vitamins for me also. I used them until I ran out, now just using a regular multi vitamin.
        Last edited by mainframe; May 16th, 2002, 08:18 PM.


        • #5
          Hi Greg

          Hang in there. Did they determine the type of palpation's you are having? PAC's maybe?

          3 months after my MVR I started getting the 'premature atrial contractions'. My surgeon thought in part to my left upper chamber returning to normal size. It was mildly enlarged prior to surgery. These irregular beats continued for 2 years. We finally stumbled across a fix and accidentally at that. They put me on Inderal LA for migraine headaches. My PAC's disappeared.

          Recently we tried to come down and off the Beta Blocker. To no avail, the PAC's returned. When having the concern, they were more pronounced when I was tired or overexerted.

          Take it easy and keep us posted. It takes a good while to get that energy level back.

          PS. What type of valve do you have?
          All the best,
          LuvMyBirman :)
          MVR, 3/99


          • #6

            My husband is 7 months post op, and gets SOB with mild exertion. Also gets palpitations at times, but he does have residual problems.

            Just a comment:

            a. Be careful with the vitamins......check to make sure the do not have K, as it will really goof up your INR.

            b. Our Boston cardio is constantly telling us that mitral valve replacement vs repair, is a very difficult trauma for the heart. More difficult to recover from than the aortic replacement. I guess they have to open up the heart on the mitral, as with the aortic they just do it from the top. You really can't compare the recover periods. My husband had both done at the same time, and now his tricuspid valve has a severe leak. So his CO is compromised.

            c. I understand it is common after having OH surgery to have palpitations, etc. You just have to take ist slow, and tgive it some time.

            d. Watch your weight. If you gain more than 3 lbs. in 24 hours, call the cardio promptly. He will get you on a diuretic.

            e. Fast heart rate is common with anemia. Most folks have anemia after getting out of surgery Mechanical valves also do some damage to the red blood cells as they shut, so most valve patients have a lowered blood count. Bottom line you need folic acid and iron....but, by Dr.'s orders only. I am certain he knows what he is doing.

            f. Do not compare your recovery with by-pass surgery....and do NOT let anyone else compare it. The surgery you had was MUCH more complex, and the heart was opened. Take it easy, my friend.

            Best wishes.



            • #7
              Great advice Maryann!

              On the vitamin front, beware of B vitamins if you are taking Coumadin. Specifically B-6. Coincidentally, it was suggested by my internist that I take it to boost my energy. The only thing it did for me was 'boost' my INR over 5.0! At the time we were still fine tuning so they had me hold for two days which brought it down to 1.2. Then they admitted me for 2 days. Placed me on the Heparin until the levels came up. All over a vitamin:mad:
              Lesson learned. Holding my Coumadin for two days does not work for me.

              Still to this day, and it has been 3+ years have a difficult time getting my doctors to believe that my INR bottoms out if I hold the 2 days. 4.0 - 5.5 and I half my dose for one day it Brings me back into range. 4.0 I leave it alone and have a salad. It truly works for me.
              All the best,
              LuvMyBirman :)
              MVR, 3/99


              • #8
                Hi Greg, I had my surgery the same day as you. I've had no palpitations since coming home (I had 4 episodes in hospital), but I am slightly short of breath. I notice it if I start to walk too quickly after standing up. I too was told that anemia was the culprit. I'm on a multivitamin (no vitamin K) to build up the iron.

                I also notice that it is much worse after I take my morning cocktail of meds. Some of the meds will be discontinued next week, so they think my SOB will likely improve a bit then.
                25 mm Aortic & 29 mm Mitral St. Jude Master Series Mechanicals - UWMC 4/16/2002
                Guidant Insignia Pacemaker - Virginia Mason Medical Center 5/19/2005
                Cardioversion Tote Board: 3


                • #9
                  Hi again Greg,

                  I read through the posts and found Tom's interesting regarding the low oxygen levels and suggestion to take "Iron" .

                  My surgeon wrote me a script for "Iron " pills and I had to take them for 2 weeks after surgery, along with many others. Down to only 3 now. But I do take a multivitimin, Centrum.

                  My daily pill intake these days consists of; 5 mg Coumadin, 50 mg Atenalol, 325 mg Aspirin, 1000mg vit "C", 400 iu "E", and a Centrum multivitimin.

                  My INR is stable, and is problably adjusted to my vitimin routine. It has been no problem staying within my recommended range.

                  3/23/00 Ascending Aortic Dissection-St. Judes mech valve+graft, Vanderbilt, Nashville, TN
                  9/16/10 ON-X Aortic Valve/Root Replacment, Cleveland Clinic,OH, Dr Pettersson
                  9/16/10 Aortic Stent and Frozen Elephant Trunk Procedure, Cleveland Clinic,OH, Dr. Roselli


                  • #10
                    Follow up

                    My hemoglobin and hematocrit are now in the normal range so my shortness of breath isn't likely to be due to the oxygen carrying capacity of my red blood cells. I placed another call to my surgeon's nurse to discuss this with her. I also went out and walked for 15 minutes today despite my symptoms. I am really out of shape and need to walk. My heart rate was only 90 after excercise and my blood pressure was normal too. I hope this is just the healing process. If this lasted I don't know what I would do!!! I wonder if they left a sponge in me or something.

                    Thanks for your feedback on this issue as it is very scary to be going through it and I really don't want to go into this with my friends because it doesn't help. It is a medical problem. My dad (physician) said to me, "Do you think you need to see a psychologist". I told him that I would if these symptoms didn't abate!




                    • #11

                      Pursue this very carefully with you cardiologist and keep on pursuing it until you get satisfaction. Marybeth is right on all the things she has said. Mitral valve surgery is difficult. While shortness of breath is not unheard of after valve replacement, it shouldn't be causing you such distress, there might be things that need to be tweaked, your meds, your diuretic, maybe you need a chest x-ray to look for fluid.

                      Irregular heartbeats can sap your strength and cause shortness of breath, too. Have your doc look into this more carefully.

                      There are always adjustments after this kind of surgery. I'm sure in time things will get ironed out.


                      • #12
                        hi greg!
                        my husband, joey, was sob for quite awhile after surgery. i remember him saying to me " i can't believe i'm even shorter of breath than i was before!! something is wrong!!" luckily, nothing was wrong.
                        i had to remind him to be patient and as his sternum healed, his sob decreased and he became able to do much more without getting winded. (he had a very hard time being patient and wanted his recovery to be instantaneous).
                        this, however, doesn't mean that it is the same case with you. please follow up if you see no progress over time.
                        nancy has a point in that palpatations/irregular beats means your heart is not beating or functioning as efficiently as it should_this could also be contributing to your sob.

                        joey's crit level was also very low and he was on iron pills for a few months. the docs said this also contributed to his shortness of breath, just as you mentioned.

                        in any case, please let us know what happens. hope you feel better,
                        my husband, Joey, had Ross Procedure 9/20/01
                        Beth Israel Med. Ctr., N.Y.- Dr. Paul Stelzer


                        • #13

                          Dear Sylvia/Nancy and everyone else who has given me advice-

                          I guess I also have to keep in mind that this is the second time that I have had heart surgery. I am also going to consult with a pulmonologist if I don't see progress over the next week.


                          • #14
                            C. R. S!


                            I don't remember much since it's been over two years, but I distinctly recall my re-hab nurse (former operating room head nurse) telling me to give it a YEAR! I think full recovery maybe took even longer!

                            I didn't even know about until at least 6 or 8 months post surgery and then it took me awhile to get into it and converse with all these incredible people. Anyway, once I got my personal routine going and new life in order I started to naturally come around. I went through a very long, dark period being challenged by vampire bats for Protimes.

                            I'm glad that I didn't push myself. Who knows where I might have ended up?!

                            I'm still learning stuff, too (from Thanks to Marybeth I just learned about the difficulty of the Mitral operation. Heck, if I would have known that, I might have saved myself $4,000 because my insurance would not accept the surgeon's bill (said it was above their reasonable and customary guidelines). I could have explained in better detail about the complexity (we tried to fight it for over 6 months). He billed $4K above somebody's guidelines, because he did two valves at once. The insurance idiots would have had me in two separate surgeries because it would look better on paper!?@!!

                            Live strong and prosper, Greg. Be patient too. You will be fine.

                            Last edited by Perrster; May 17th, 2002, 02:32 PM.


                            • #15
                              That's good Greg, keep after it. I think sometimes, when you have had a long stint of heart problems, your lungs get lazy and accustomed to a weak situation, when you get your heart fixed up, it puts more pressure on the lungs to "get moving, you lazy so and so" and that's why they push the spirometer so much in the hospital, plus they don't want anyone getting pneumonia. Everything has to get in sync, it will sooner or later

                              Sounds like you have a good plan to see the pulmonologist.