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Arjun Khosla
Arjun Khosla, Doctor
Category: Medical
Satisfied Customers: 10
Experience:  Urologic Surgeon
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I had surgery today to remove a malignant breast lesion

Customer Question

Hi I had surgery today to remove a malignant breast lesion along with two lymph nodes ...during surgery I had an episode of Brady cardia in which my heart rate went down to 28 ..I was given atropine to counter the episode ...I am very bothered by this ..what would cause such a significant drop .I am relatively healthy do lots of cardio etc ...I'm worried because there may be cause for more surgery regarding the breast cancer .does bradycardia occur in this manner at times and am I risk
Submitted: 11 months ago.
Category: Medical
Customer: replied 11 months ago.
Also I'm age 46 female .from.what I've read this is considered an adverse reaction
Expert:  Arjun Khosla replied 11 months ago.

Hello, I would be happy to help answer your question. I am a surgeon and often see episodes like this in the operating room...

Expert:  Arjun Khosla replied 11 months ago.

There are many possible causes for bradycardia, and some of them are specific to someone undergoing surgery in the operating room.

Some people will have an intrinsic reason for bradycardia - such as a history of heart disease or arrhythmias- which predispose their heart to vary in rate/rhythm. However, given your young age and lack of any prior heart condition, this is less likely of a scenario. Also, the anesthesiologist who gave you the atropine would look for any abnormal signal in your EKG during the episode of bardycardia...any abnormality should be fully worked-up and evaluated with subsequent blood tests and EKGs after the surgery.

If, on the other hand, the bradycardia was simply a slowed heart rate, without any other concerning findings, there can be a very explainable reason for the slowing of your heart rate. When giving general anesthesia during an operation, there is a fine balance between giving enough medication so that the patient is comfortable and completely anesthetized, while not giving too much as to cause significant problems (such as death, for example). Each patient's titration is a little different and that is why there is so much monitoring involved during these procedures - to keep a very close eye on all vital signs to make sure everything is in check. So, sometimes, a dose of anesthetic can cause a change in heart rate or blood pressure, which is then treated accordingly with the appropriate your case, that was atropine. These adjustments in medication to treat changes in the vital signs are very commonly done and if there was a sudden, inexplainable reason for your bradycardia, there would have been a very thorough cardiac workup, like mentioned above. In addition, the positive pressure in the thoracic cavity from the ventilator that was breathing for you, can activate a specific nerve (the vagus nerve) that can cause a sudden drop in your heart rate or blood pressure...this can even be seen in awake patients who suddenly faint after straining heavily. This eventually recovers with supportive measures and time.

I hope this information helps. Overall, I would not be too worried unless the anesthesiologist saw something unusual. Feel free to let me know if you have any other questions or concerns. Whenever you get a chance, I would appreciate if you could rate my response. Thanks so much and take care!

Expert:  Arjun Khosla replied 11 months ago.

Is there anything else I can help you with?