Extra systoles, pulsations, etc.

[Gena50]

Dear Sir/Madam:

I had a bypass surgery done in Germany about 6 month ago. I received 5 bypasses (artery grafts). My heart pump function was about 34% before the operation and currently is about 37-40%.

However, I am experiencing problems with my heartbeat, especially at the time of getting into a horizontal position on my back, e.g. when trying to get a sleep at night or getting a nap during the day.

Indeed, I feel strange pulsations in the chest I have also been experiencing extra systoles since the first days after surgery. German doctors told me that extra systoles are NOT life-threatening and should come down with the time but I am not so sure.

Frankly, I am having difficulties of getting a sleep each night because of these strange pulsations in my chest. I understand that the graft arteries are causing this problem. I also noted that after taking a higher dosage of Beta-blocker, the pulsations are coming down.

What should I do in such a case? Will the aforementioned pulsations and extra systoles disappear in due course or it means that my surgery was done incorrectly?

Thank you in advance for your help.

Regards,
G.

P.S.  Before the aforementioned surgery I have not had any difficulties of getting a sleep at night or during the day.

[Michael J. McWilliams, M.D.]

What should I do in such a case? Will the aforementioned pulsations and extra systoles disappear in due course or it means that my surgery was done incorrectly?

Only time will tell the what will happen.  They sometimes resolve and other times are persistent.  It is true that some people have more PVCs after bypass surgery and they stabilize with time.  There is no way to know.  I agree that beta blockers, ace inhibitors, and aspirin are mainstay therapies for coronary artery disease.  In the United States we would probably re evaluate your heart function several months after bypass surgery and if your heart function is less than 35% and significant symptoms, a defibrillator is often recommended.  If you you heart function is over 35%, medical management is advised.

I hope this helps and I wish you a speedy recovery.

[Gena50]

Appreciate your prompt reply.

Sorry, I only just opened and read your reply. You are right --- a lot depends of my ability to recover.

However, I might have NO chance to recover, if any avoidable mistakes were made during the bypass operation. That is/was my concern!!!  

I just suspect that some artery grafts were NOT correctly connected, etc.  Because I almost constantly feel my heartbeat on the left side of my chest and back (the arteries are too close to the chest wall or how it is called?). The X-ray shows that my heart was moved to the left side (although it was probably unavoidable!!!).

The guy who did the my bypass operation (Oberartz – in German) had a good reputation and track record, but one never knew what could get wrong!!! Or may be he did best in the situation. However, after infarct and before the bypass operation I had no feelings of strange pulsations or extra systoles!!!

I only hope that with God help everything will settle down at the right time.  Of course, the heart function will be the best indicator of progress.

Thanks again for your advice.