Having any surgical procedure, including a total joint replacement, puts stress on the heart and the cardiovascular system. It is vital to make sure that your heart is healthy enough to support itself during certain changes to the heart rate during surgery and the use of anesthesia. These changes caused in surgery can uncover previously undiagnosed heart disease, so it is important to take the steps to prevent the risk of heart complications.
Measures should be taken to ensure the health of your heart during the postoperative phase of your care, and now that you may be feeling more mobile and pain free following a joint replacement, it is necessary to maintain proper cardiovascular health as well.
Assessments can be done to make sure your heart is healthy enough to go through the surgery, especially if your physician thinks you are at risk for heart disease or have a history of heart disease. Following a physical exam, usually done by a primary care physician, risk factors can be assessed for heart disease and additional testing can be done by a cardiologist for final surgical clearance. Common tests include:
1. Resting ECG or EKG (electrocardiogram)- this test measures the electrical impulses traveling through the heart. It can evaluate if your heartbeat is slow, fast, normal or irregular. The test can also determine if parts of your heart are overworked or are too large for the electrical impulses to pass through properly. The test is non-invasive and pain free.
2. Exercise Stress Test- If you are physically active enough to perform an exercise stress test, your heart rate, blood pressure, and breathing are monitored as well as an EKG being used to monitor your heart while walking on a treadmill. The pace and incline is gradually increased to produce more of a workload on the heart, and monitor how it responds. The test is always monitored by a medical professional and is usually short in time and you are able to recover with a few minutes of rest.
3. Pharmacological Stress Test- Which often is the case in patients in need of joint replacement surgery, they are not mobile enough to be able to perform an exercise stress test. A pharmacological stress test can be done using pharmacological agents along with diagnostic imaging to evaluate the heart’s response to stress. You may be asked to not eat or drink before the test, and the test can take an hour or two to complete. The pharmacological agents used in the stress test are naturally flushed out of your body following the test, and the side effects are low. You are able to continue with your regular daily activities following the test.
Following your surgery you are continually monitored for your heart rate, blood pressure, and oxygen saturation. These vitals are monitored along with the use of pain medication as the anesthesia wears off. Physical therapy is scheduled to get you moving as soon as you are able, and this activity can prevent blood clots and other post-surgical complications caused from immobility.
During the recovery phase from your surgery it is also important to engage in certain lifestyle changes that can help with the health of your heart. These include:
1. Diet- Eating a diet consisting of healthy fats, whole grains, fruits, and vegetables can provide your body with what it needs for the heart to recover from the stress of surgery. Avoiding foods high in sodium, sugar, saturated and trans fats can also aid in heart health. Alcohol intake should be limited due to blood pressure and weight gain increases it may cause.
2. Exercise- Now that you are most likely able to move better with less pain, you should continue with an exercise program that will make your heart stronger. Aerobic exercise which is safe for total joint patients, such as walking, biking, or swimming can improve the heart’s ability to pump oxygen to the rest of the body, increasing the heart’s health. It is recommended to exercise aerobically for 30 min a day, so if you are new to getting back to exercising following surgery, be sure to work up to 30 minutes incrementally.
If you have concerns regarding your cardiovascular health and surgery, make sure to speak with your specialist at the Heekin Clinic, who will be happy to guide you through the steps to making sure your heart is healthy before and after surgery.