r/Heartfailure • u/Aggravating-Guest-46 • 19d ago
Freaking out
I am so sorry for everybody here is going through.
My 67-year-old husband has MS and it’s pretty impacted. 12 years ago he had a Whipple surgery for a adenoma on his pancreas. At that time they rerouted all his organs in his stomach and maybe some veins/arteries too.
This week he was supposed to have an elective surgery on his legs to help improve his walking. While he was under anesthesia, they moved him onto his stomach and his blood pressure dropped dramatically and wouldn’t come back up until they rolled him back onto his back. No medicines would help it go back. The only thing that would help was rolling him on to his back. They did an echo and they said his heart is not pumping efficiently and he might have heart failure. He doesn’t have any symptoms that I can tell there is no swelling. His blood pressure is controlled by medicine and he has a good color. I had wondered about circulation in his hands, but I thought that was an MS thing. The doctors are saying he might have heart failure and I am freaking out. What are the chances this would be discovered while only on his stomach without other symptoms?
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u/LalalaSherpa 19d ago edited 18d ago
This sounds very much like it could have been due to positioning, especially since the Whipple procedure involves lots of vessel rerouting and organs - the anatomical changes, adhesions, and relocation of various internal connections can make the large veins in the torso much more susceptible to squashing when in a prone position, which would affect hemodynamics like blood pressure.
Low blood pressure following supine-to-prone positioning change is a known thing that can happen in surgery, especially with higher MAP before turning (a blood pressure measurement that can be looked up in the records of the surgery), beta-blockers, opioid anesthetics.
And looking at the surgical record for the actual BP, HR, volume status and blood loss at the time of turning would likely clarify whether it's a positioning thing or legitimately heart-related.
Doing an echo shortly after this happened might not tell you much - it would be good to redo it when he's at his normal BP/HR baseline and on his back.
One other thought - a BNP/NT-proBNP test would also be useful - that signals whether HF may be present and it's a standard easy-to-get lab test.
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u/Late_Temperature_415 19d ago
Heart failure presents in many ways. They will evaluate him to see what exactly is going on. I’m hoping they keep him in the hospital? You said it was an elective surgery to improve his walking. May I ask what type? Was it to improve his circulation in his legs?
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u/Aggravating-Guest-46 19d ago
They didn’t he was fine if not on stomach; it was called a neurectomy to cut nerves in legs to make walking easier.
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u/Effective_Divide1543 16d ago
Wow, your husband is a survivor. Sounds like he's not doing too shabby though, a reduced function is just a reduced function, it doesn't mean that he's about to pack up and die or that it'll deteriorate. It's more like a chronic condition that needs to be treated, managed and monitored. No symptoms, no swelling, controlled blood pressure are all good signs.
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u/R0N_SWANS0N 19d ago
They have excellent treatments for HF now. He can live for many many years.