Shortness of Breath After Open Heart Surgery

Shortness of breath is one of the most common side effects of open heart surgery, especially in the first few days after the operation. There are several reasons why.

Heart muscle recovery

In the short term, your heart needs time to recover and fully regain its pumping ability after open heart surgery. As a result, you may feel winded as you resume walking and doing other activities.

As you rebuild your strength and endurance, your cardiovascular fitness will likely improve with time.

Mucus buildup

Being on a ventilator while under general anesthesia triggers a buildup of mucus or secretions in the airways in your lungs. Taking deep breaths and exhaling with some exertion is one way to help clear your lungs of mucus.

However, because inhaling and exhaling deeply are difficult and sometimes painful after heart surgery, your lungs can’t expel mucus as they normally would. This, in turn, can cause shortness of breath.

Atelectasis

“Atelectasis” is the clinical term for the collapse of the small airways in the lungs that can lead to decreased oxygen levels in the body. Anesthesia and prolonged bed rest with little change in position are major risk factors for atelectasis.

A 2018 study suggests that atelectasis is the main cause of shortness of breath after cardiac surgery.

Pleural effusion

Pleural effusion is the buildup of fluid between the layers that line the outside of your lungs and chest cavity. This space is known as the pleural space.

One of the reasons chest tubes are placed after open heart surgery is to prevent pleural effusions from occurring. Pleural effusions can be a potentially dangerous side effect of open heart surgery.

A 2022 study with more than 11,000 people who had heart surgery suggests that pleural effusion was associated with higher rates of death and longer hospital stays. It was also associated with higher rates of postsurgery complications.

Pneumonia

Pneumonia is an infection of the air sacs in one or both lungs. It’s the most common infection associated with open heart surgery.

According to a 2021 study with more than 5,000 people who had cardiac surgery, 9.96% of them developed pneumonia. It led to longer stays in the intensive care unit and higher rates of death.

If you have a preexisting respiratory condition, such as asthma or chronic obstructive pulmonary disease (COPD), shortness of breath after open heart surgery is expected.

Moreover, shortness of breath is more likely to persist for longer after the procedure with these preexisting conditions.

If you don’t have a preexisting respiratory condition, it’s harder to predict how long shortness of breath will last after open heart surgery.

Researchers in one 2016 study looked at lung function after heart surgery. They found that while breathing problems are common right after surgery, breathing issues can also persist for 4 to 6 months or more after surgery.

However, researchers also found that unless there are complications such as pneumonia or other severe illnesses or side effects, shortness of breath problems usually resolve within a few weeks or months.

While the overall rate of death associated with heart surgery is just 2% to 3%, the procedure does have some potentially serious side effects, such as:

• Arrhythmias: Arrhythmias are heart rhythm disturbances that can lead to complications such as stroke or heart failure.
• Bleeding complications: You may have a higher risk of bleeding complications if your blood can’t clot properly or if you’re taking blood-thinning medications.
• Blood clot: A blood clot that forms in the heart can raise the risk of an ischemic stroke.
• Infection: An infection can cause inflammation and other complications.
• Brain fog: Brain fog is typically the result of anesthesia and time spent on the heart-lung machine. It usually resolves with time.

Several strategies may help reduce the severity and duration of breathing problems after open heart surgery.

Your doctor may recommend cardiac rehabilitation. With this type of rehabilitation, a respiratory therapist teaches you specific techniques to strengthen your lungs and make breathing easier.

The following strategies may be especially helpful:

• Breathing exercises: Breathing exercises may take some effort, especially at first. One example of a breathing exercise is to take in a slow deep breath, hold it for a few seconds, and then slowly exhale. Try to do 3 or 4 sets of 10 repetitions throughout the day.
• Breathing aids: There are many types of breathing aids you can use at home, from medications to supplemental oxygen. You may be advised to try a continuous positive airway pressure (CPAP) device while you sleep. This device can help keep your airways open to ensure a steady flow of oxygen into your lungs.
• Gentle exercise: Walking can boost your heart and lung function. It can also help clear mucus from your airways.

Before trying any exercises or activities on your own, get clearance from your healthcare team.

Your respiratory health should gradually improve as you recover from heart surgery.

If you find that you have shortness of breath that gradually seems to be getting worse or does not get better in the weeks after surgery, make an appointment to visit your cardiologist.

Shortness of breath after open heart surgery is common, so don’t be alarmed if it takes time to resume healthy, normal breathing.

You may be winded more easily until your endurance builds up. You may have a cough that persists as your lungs continue to clear.

For many people who get open heart surgery, cardiac rehabilitation may be necessary to help improve respiration and lung function. A respiratory therapist can teach you various breathing techniques to help strengthen your lungs and keep your lungs clear while your heart recovers from surgery.

Be sure to follow all instructions from your doctor and cardiac care team after open heart surgery. Being diligent about exercises and therapy can help speed up your recovery.