Post-Surgical Sinus Tachycardia

[ncw3642]

Hi all,

I am now day 5 post-

“1. Minimally invasive mechanical composite root replacement via modified bentall conduit (On-X valve 27/29 mm / 26 mm Gelweave Valsalva graft)

2. Left main intramural coronary artery unroofing

3. Sternal plating”

And since day 2-3 I have been having constant sinus tachycardia at rest (100-110bpm) and rising up to 130-135 with walking.

Doctors don’t seek concerned and have continued to up my Beta Blocker dose but I wanted to see if anyone else has experience with this? Doctor said it’s more normal in younger patients (I’m 27) and I’ll likely need the blocker at home for an undetermined amount of time (maybe forever it it doesn’t resolve).

They just got me disconnected off my heparin drip as my PTT was 82 overnight (64 this morning) and my IRN is 1.9 so they are going to manage with just Coumadin now.

Still having some shallow breaths due to a lot of pain with inhalation. Chest X-Ray shows a small left pleural effusion but they say that will resolve with more time and walking

Thanks for all the input!

 

[3mm]

Overall, this sounds pretty good!

Sternal plating

Did they use a plate with screws to close your sternum instead of wires? If so, why?

 

[ncw3642]

Overall, this sounds pretty good!

Did they use a plate with screws to close your sternum instead of wires? If so, why?

Yes!

My surgeon has been following a lot of research regarding early healing and mobility. Plating is used to reinforce wires so both are still used.

Pending symptoms, here are the updated guidelines approved by our 4 hospital surgeons for plating at discharge and the weeks following.

It allows me to, in theory, be more active and get back to my old activities including caring for my newborn.

 

[pellicle]

My surgeon has been following a lot of research regarding early healing and mobility. Plating is used to reinforce wires so both are still used.

interesting, are they (the plates) removed or do you have two sets of junk inside now?

My junk inside, this is from 3 OHS over quite a number of years:

the yellow areas circle some staples (got knows why they're there) ... you can find more.

And since day 2-3 I have been having constant sinus tachycardia at rest (100-110bpm) and rising up to 130-135 with walking.

not so bad ... I think I was 120 a lot in my first days back on the ward. I actually developed full sinus tachycardia (just over) 10 years after OHS #3 and remain on metoprolol as it creeps back without it.

They just got me disconnected off my heparin drip as my PTT was 82 overnight (64 this morning)

surprised anyone bothers reporting PTT anymore, its means pretty much nothing anyway.

and my INR is 1.9 so they are going to manage with just Coumadin now.

INR of 1.9 is the bottom end of ok range, I expect it'll be up to 2.5 sooner or later.

Still having some shallow breaths due to a lot of pain with inhalation. Chest X-Ray shows a small left pleural effusion but they say that will resolve with more time and walking

sounds like the usual stuff ... in a few weeks it'll most likely all just be a dim memory.

Best Wishes

 

[ncw3642]

interesting, are they (the plates) removed or do you have two sets of junk inside now?

My junk inside, this is from 3 OHS over quite a number of years:
View attachment 890351
the yellow areas circle some staples (got knows why they're there) ... you can find more.


not so bad ... I think I was 120 a lot in my first days back on the ward. I actually developed full sinus tachycardia (just over) 10 years after OHS #3 and remain on metoprolol as it creeps back without it.


surprised anyone bothers reporting PTT anymore, its means pretty much nothing anyway.


INR of 1.9 is the bottom end of ok range, I expect it'll be up to 2.5 sooner or later.



sounds like the usual stuff ... in a few weeks it'll most likely all just be a dim memory.

Best Wishes

Hi!

Plates will remain in my body as more ‘junk’ forever but hoping it allows continued stability for anything higher impact down the road.

They just bumped up my metrapolol to 50mg 2x a day and it’s still running 100-110- seems to have some relief upon initial intake- worse towards end of medication time.

Yes. Hoping they give some formal directions on how frequent to monitor INR/how to change dose prior to discharge tomorrow but I also know if I have questions- this is a pretty good community to loop back to!

Hoping my HR stabilizes soon honestly. But open to it taking weeks or months.

 

[pellicle]

metrapolol to 50mg 2x a day and it’s still running 100-110- seems to have some relief upon initial intake- worse towards end of medication time.

wondering if that is metoprolol tartrate or succinate (just interested) because both have different "release patterns"; seen here:

give that graph a careful look as the 50mg metoprolol tartrate line only goes half the width, but the 100mg does full length and the succinate does too.

But open to it taking weeks or months.

if I recall correctly mine was somewhere in that range too

Best Wishes

 

[Beach77]

@ncw3642 I also had pleural effusion while in the hospital. A follow-up appointment was made before I left the hospital. After that appointment, a thoracentesis was scheduled. This all took place within the first week or so after my release from the hospital. After the procedure, my breathing pain was immediately gone!!! That's when I was able to really start walking! It was a little scary reading about it, but outcome was amazing!!! I went to barely walking a few steps to walking around the block! I had a few afibs/tachycardia in the hospital and used metropole for 30 days. Everything to settle down during those 30 days. Yay! Metropole isn't my favorite medicine. (gave me horrible nightmares) About 6 months later, I started having tachycardia again, with heart rates going to 170 to 190's lasting 30 mins. It turned out my thyroid levels were out of range. Now I'll get them a few times a year, they last less than 3 mins. I track them for my doctor and so far he's not worried. It's been 3 1/2 years since my surgery and I'm really happy with my heart rate now!

It was interesting reading about your plate too.

Good luck with your recovery! You'll be holding your baby soon!