Can I undergo surgery under general anesthesia with cardiomyopathy?

Question

Hi doctor,

I am a female, and I had a history of PVC-induced cardiomyopathy, which was cured by ablation. That was more than six years ago, after which my heart returned to normal. I have maintained good cardiac health the entire time. Eleven months ago, I very suddenly lost the hearing in my left ear, SSHL, no explanation. At first, it was profound, and then after steroid treatment, I regained about 50% of the hearing, but I continue to have lousy tinnitus. Around the same time, I started experiencing pelvic pain. It took many months before I took it seriously and had ultrasounds and MRIs. My doctors could not agree that a 7 cm ovarian cyst and a uterine fibroid were causing my pain. Finally, I have been scheduled for laparoscopic removal of the cyst and the fibroid this week. My question is not gynecological but is about my cardiac status for such surgery. I last had my echo about eight months ago, it is normal, and I have attached it. My cardiologist says there is no need to repeat it before my surgery. I will be going under general anesthesia and have never been under it before. I was fully awake and without a painkiller during my ablation as the EP wanted to make sure the arrhythmia was at its worst during the surgery. I am anxious about the anesthesia, given my cardiac history. I know that fatal complications are rare, but I worry that I am more susceptible to other complications, particularly my blood pressure. While I had never sustained high blood pressure, I had a few higher readings when I was in severe pain and highly anxious. If I have significant pain from the cyst when I go into surgery and nervous, I may have higher than normal blood pressure. At my last echo and checkup previous year, it has been normal. Can blood pressure go up quickly from stress and pain and stay elevated? I know I have, generally, been healthy other than my transient cardiomyopathy. Still, with the hearing loss and the severe pelvic pain, I feel unwell, and I am concerned about the safety of a procedure under general anesthesia. However, I know there is no alternative. I am going to an outstanding gynecologic surgeon, but I remain anxious. Thank you for your help now and for many years. I hope you are doing well.

Answer 1

Hello,

Welcome to icliniq.com.

I am glad to hear from you. I passed carefully through your question and would explain that there is no reason to fear the surgery, as your cardiac ultrasound is within the normal range. I am sure that everything will be fine, as you are going to have surgery with a professional staff, who deal with patients with a lot of comorbidities and is well prepared. You should know that there is no contraindication to anesthetic drugs or general anesthesia in your clinical situation. Regarding hearing loss, it is not related to the heart but an inner ear disorder. It is not aggravated by anesthetic drugs too. So, do not panic. Regarding the pain, I suggest tablet Acetaminophen four times daily. It does not raise blood pressure values, and it is a good painkiller after surgery. But, I am sure that you will be fine at the hospital, as doctors use drugs that do not interfere with high blood pressure and help calm the pain and the anxiety. So, you should try to keep calm and be more optimistic as everything will be fine. I hope you will find this information helpful. I remain at your disposal in case of further questions whenever you need me. I wish you all the best.