Shortness of Breath After Surgery – Possible Causes

What are the possible causes of shortness of breath after surgery?

Shortness of breath has many different causes affecting either the heart or blood vessels or the breathing passages and lungs.

Some people may experience shortness of breath suddenly for short periods of time, especially after some types of surgery, like:

Gallbladder Removal

Gallbladder surgery solves the problem of gallstones, which are hard deposits of the digestive fluid in the gallbladder.

There are 2 main methods of performing gallbladder removal:

• open;
• laparoscopic.

Both methods are performed under general anesthesia, hence, you’ll be “out” during the medical procedure.

Open Heart

Open heart surgery is a general term referring to medical procedures in which the chest is cut open to access the heart. Types of open heart procedures include:

• implantation of Left Ventricular Assist Device;
• valve procedures;
• aortic valve and arch replacements;
• mitral valve repair and replacement;
• coronary artery bypass graft surgery, including Thoracoscopic CABG and off-pump CABG;
• heart bypass surgery – it is used to replace damaged arteries which supply blood to the heart muscle. By creating a new pathway to the heart, this surgery improves blood flow to the heart muscle.

Abdominal

Abdominal surgery refers to a medical procedure that affects the abdomen, including gastrointestinal conditions and weight loss procedures.

Lobectomy

A lobectomy is a surgery to remove one of the lobes of the lungs. There are 2 lobes in your left lung and 3 lobes in your right lung. In most cases, it is performed to prevent cancer from spreading and to remove a cancerous portion of an organ.

Causes of Shortness of Breath After Surgery

Pneumothorax

It is the clinical entity that is characterized by an abnormal collection of gases or air in the pleural space which separates the lung from the chest wall.

If there have been no further complications and is only a small amount of air trapped in the pleural space, it can often heal on its own.

Postoperative Bleeding

Surgical problems can cause postoperative bleeding. For instance, stitches may have come apart or blood vessels may require to be secured.

In some cases, the bleeding may be a sign of a serious condition and you should seek immediate specialized medical attention.

Intravenous Fluids Administered During Surgery

Intravenous fluid therapy for routine maintenance refers to the provision of intravenous fluid and electrolytes for sufferers who cannot meet their requirements by oral or enteral routes.

Also, both excessive and little fluid administered during the intraoperative period can adversely affect patient outcome.

Pulmonary Embolism (PE)

A blood clot is an abnormal blockage of blood flow in the vessels returning blood to the heart. It is caused when the blood coagulates inappropriately.

A pulmonary embolism is a blood clot in your lungs. It can be in an artery near the edge of the lung or in one in the center of the lung.

The blood clots that cause pulmonary embolism typically originate in the deep veins of the leg, a condition called deep vein thrombosis. When a clot blocks a pulmonary artery, one symptom is shortness of breath. A massive pulmonary embolism can cause collapse and death.

Warning signs and symptoms of a pulmonary embolism include:

• an unexplained cough, occasionally with bloody mucus;
• rapid heart rate;
• chest pain that is sharp or stabbing;
• sudden shortness of breath.

To prevent pulmonary embolism, your healthcare provider may prescribe heparin or warfarin (Coumadin), which are blood thinners medications. In addition, these medications can help any clots which the patient currently has from getting bigger.

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Atelectasis

Atelectasis develops when the tiny air sacs within the lung become deflated. It may be the result of pressure from outside the lung or of a blocked airway.

It can happen during or after any surgical procedure since these medical procedures typically involve using a breathing machine followed by pain medications and anesthesia.

Symptoms of a collapsed lung vary, and they may include:

• shortness of breath, which can be sudden and extreme;
• shock with a rapid heart rate and a severe drop in blood pressure;
• if the symptoms are severe and the blockage occurred quickly, it leads to sharp pain on the affected side;
• rapid, shallow breathing;
• fever if an infection is present;
• falling oxygen levels in the blood, which causes the patient to look bluish.

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Prevention

Perform Deep Breathing Exercises

These exercises are very important after surgery for the prevention of shortness of breath. Practicing deep breathing exercises can also be calming and energizing and can even help to reduce your stress levels.

Incentive Spirometer

While in the hospital, you may use an incentive spirometer, a device used to help you keep your lungs healthy when you have lung illness or after surgery.

Tip – when you are using an incentive spirometer, make sure to breathe through the mouth.

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Note

See your medical professional immediately if your shortness of breath is accompanied by:

• breathlessness that does not go away after half an hour of rest;
• worsening of pre-existing shortness of breath after using your inhalers;
• stridor – a high pitched noise that occurs with breathing;
• wheezing – abnormal whistling type of sound when you breathe in or out;
• fingertips or lips turning blue;
• high fever and chills;
• trouble breathing when you lie flat;
• swelling in your ankles and feet.

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References

https://www.ncbi.nlm.nih.gov/pubmed/29738108
https://www.sciencedirect.com/science/article/pii/S0954611106000473
https://onlinelibrary.wiley.com/doi/pdf/10.1111/acem.13118