Tachycardia After Surgery - Causes, Symptoms, and Prevention

Understanding Tachycardia After Surgery

It's normal to feel anxious before undergoing surgery. The procedure itself, anesthesia, pain medications, and other factors can cause your heart to beat faster after the operation. While an elevated heart rate is common, tachycardia following surgery can be concerning. Let's take a closer look at this condition.

What is Tachycardia?

Tachycardia refers to a heart rate over 100 beats per minute. A normal resting heart rate is between 60 to 100 bpm. Tachycardia occurs when the electrical signals in the heart's upper chambers fire abnormally. This causes a rapid heartbeat. Based on the underlying cause and heart rate, tachycardia is categorized into:

• Sinus tachycardia - Heart rate between 101 to 150 bpm
• Supraventricular tachycardia - Heart rate between 150 to 250 bpm
• Ventricular tachycardia - Heart rate greater than 250 bpm

Sinus tachycardia is the most common type after surgery. It occurs when the body's normal physiological response raises your heart rate above 100 bpm. Supraventricular tachycardia (SVT) results from improper electrical signals in the heart's upper chambers. Ventricular tachycardia originates from the lower chambers and is the most dangerous rhythm.

Why Does Tachycardia Happen After Surgery?

There are several reasons why your heart may start beating faster following surgery:

• The stress of surgery triggers the body's "fight or flight" response, releasing stress hormones like adrenaline and noradrenaline. These hormones increase your breathing and heart rate.
• You may experience blood loss and low blood pressure during the operation. To compensate, the heart pumps faster to circulate more oxygen and nutrients throughout the body.
• Anesthesia and medications given before, during, and after surgery can affect heart rate. For example, epinephrine in local anesthetics acts like adrenaline.
• The respirator tube placed for general anesthesia can irritate the vocal cords and trigger a reflexive heart rate response.
• Pain after surgery places more demand on the body, increasing metabolic activity. Your heart beats faster to meet this increased demand.
• Dehydration and electrolyte imbalances can disrupt the heart's normal electrical signaling.

Risk Factors for Developing Tachycardia

Certain factors may predispose you to tachycardia following surgery:

• Being overweight or obese
• Older age
• Cardiovascular disease like coronary artery disease or heart failure
• Excessive alcohol use
• Smoking
• Hyperthyroidism
• Electrolyte abnormalities
• History of tachycardia including atrial fibrillation
• Medications like beta-agonists, caffeine, decongestants
• Genetic predisposition

Discuss your medical history thoroughly with your doctor. This will help determine if you are at higher risk of developing rapid heart rhythms after your procedure.

When Does Tachycardia Usually Occur After Surgery?

Tachycardia commonly occurs:

• During surgery - The surgical stress response, anesthesia, and other medications can increase heart rate once the procedure begins.
• In the post-anesthesia care unit (PACU) - As anesthesia wears off, you may experience a transient spike in heart rate and blood pressure. This is usually temporary.
• Within 24 hours after surgery - Factors like anxiety, pain, and postoperative complications can raise heart rate during this period.
• A few days after discharge - Dehydration and not moving around can cause tachycardia several days after leaving the hospital.

Your healthcare team monitors your heart rhythm continuously during and immediately after surgery. They also check your pulse and blood pressure routinely once you are moved to the general hospital floor until discharge.

Signs and Symptoms

The most common symptom of tachycardia is palpitations - a feeling that your heart is pounding, fluttering, or racing. Other signs and symptoms can include:

• Chest pain or pressure
• Shortness of breath
• Lightheadedness or dizziness
• Fainting or near fainting
• Weakness and fatigue
• Reduced ability to exercise
• Sweating
• Pallor
• Pulse deficit - Difference between the apical pulse and radial pulse rate

Diagnosing Postoperative Tachycardia

If you develop symptoms of tachycardia after surgery, your doctor will evaluate your condition through:

• Medical history - Discuss any previous episodes of rapid heart rate and related symptoms.
• Physical exam - Your heart rate, blood pressure, respiratory rate, oxygen levels, and breath sounds will be checked.
• Electrocardiogram (ECG) - An ECG measures the electrical activity of the heart and can determine what type of tachycardia you have.
• Blood tests - These check for anemia, electrolyte abnormalities, thyroid disorders, and cardiac enzyme levels that may cause tachycardia.
• Echocardiogram - An ultrasound of your heart to rule out structural problems contributing to the rapid rhythm.
• Stress test - Used to observe how your heart rate and blood pressure respond to controlled levels of exercise.

Based on the test results, your doctor can prescribe the appropriate treatment.

Treating Tachycardia After Surgery

Treatment depends on the underlying cause and your symptoms:

• Wait and observe - If you have sinus tachycardia without symptoms, your healthcare providers may just monitor your heart rate until it resolves on its own as you recover.
• Medications - Drugs like beta blockers, calcium channel blockers, and antiarrhythmics help control heart rate and rhythm.
• Fluids and electrolytes - IV fluids and electrolyte replacement helps reverse dehydration and imbalance.
• Oxygen - This increases oxygen supply to the heart muscle.
• Treating underlying condition - Any contributing factors like infection, blood loss, or thyroid disorders will need to be addressed.
• Electrical cardioversion - This procedure uses electrical shocks to restore normal sinus rhythm in unstable patients.

If medications do not resolve the tachycardia or you are hemodynamically unstable, your doctor may recommend further treatment like cardioversion, implantable devices, surgery, or catheter ablation.

Preventing Tachycardia After Surgery

You can take certain precautions to lower your risk of developing a rapid heartbeat after surgery:

• Follow your prescribed medication regimen before the operation. This includes beta blockers, antiarrhythmics, etc.
• Tell your surgeon about any prior episodes of irregular heart rhythms and related symptoms.
• Address modifiable risk factors like obesity through diet, exercise, and lifestyle changes.
• Quit smoking and avoid secondhand smoke exposure.
• Limit alcohol and caffeine intake.
• Carefully monitor your fluid intake and electrolyte levels after discharge.
• Attend all follow-up appointments so your cardiologist can monitor your progress.

Talk to your doctor to create a customized plan to keep your heart healthy before and after your procedure.

When to Seek Emergency Care

In most cases, postoperative tachycardia resolves on its own or with medications. But some symptoms require prompt medical attention:

• Lightheadedness, confusion, blurred vision
• Passing out
• Chest pain or pressure
• Difficulty breathing
• Heart rate over 150 bpm

If you experience any of these signs, call 911 or go to the nearest emergency room. Timely treatment is crucial to prevent complications like stroke, heart attack, and sudden cardiac death.

The Bottom Line

It's common for your heart to beat faster as your body recovers after surgery. Mild tachycardia often resolves without intervention. But a persistently rapid rhythm requires medical care to avoid serious consequences. Addressing modifiable risk factors, following your doctor's recommendations, and promptly reporting any concerning symptoms can help prevent complications.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.