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What causes heart palpitations and shortness of breath post gastric sleeve surgery?

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Posted on Tue, 10 May 2016
Question: I had Gastric Sleeve surgery on 12/8/15. Because of complications I was hospitalized for nearly 2 months. I have had two EGD procedures with dialation for two strictures that developed.
I am home now but can still only drink liquids. Everything I try doesnt stay in for long.
Now I am experiencing heart palpitations,shortness of breath, rapid heart beat,shoulder and chest pain. Also everytime I stand I feel like I am goinf to pass out. Most symptoms get worse with physical activity of any kind. Oh and I am also having pain and a burning sensation in the veins of my upper thigh and calf.
What could this be?










doctor
Answered by Dr. Mukund Savaskar (1 hour later)
Brief Answer:
Post Sleeve Complications / Under Evaluation

Detailed Answer:

Hi,
Thanks for your query to HCM.
I have read and reviewed facts of your query in context to health complaints.

You seem to suffer from Post- Sleeve Dumping from more intake loads.
In view of the stenotic complications in your case, you need to go slow to avoid these complaints .
Please update the exact liquid diet you are on- give me details with the timing schedules, to guide more on these health issues.

Suggestions-
Take less quantity / volume of liquid food.(instead of 3 big meals, take 5 small ones)
Reduce solid content and increase liquid content in your feeds.
Don't increase the quantity/Volume of liquids, even by accident.
Repeat intake after first,if needed-with sufficient time interval to reduce these complaints.
As you are still on liquids, this would relieve the complaints in your case.

Your other complaint of burning in thigh and calf- is mostly from - Venous Thrombosis after chronic hospitalization and needs to be assessed with Color dopler study and evaluation from Vascular Surgeon there after.

Hope this would resolve your anxiety and would help in planning treatment with your doctors there.

Welcome for any further query in this regard.

Please update more details of your diet, if you need more and further help.

Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS


Above answer was peer-reviewed by : Dr. Deepak
doctor
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Follow up: Dr. Mukund Savaskar (4 hours later)
My Bariatric Surgeon's liquid goals for me are 70 grams of protein and 64 oz of fluids. I am getting 20 liquid grams of protein and close to 32 oz of total liquids a day. I should be eating solids according to my Nutrionist...but my sleeve will not tolerate even pureed or any soft foods. One teaspoon of mashed potatoes (as recommended to try by my nutrionist) came up within 5 min. So I am having the chest pain,palpitations etc, as I describe earlier,even when it has been days since I tried any type of "food" and even on days when I have no nutrition at all. Are those symptoms related to dumping syndrome, even if I have not eaten? I have not had any solid foods. And have not had a "meal" since my 12/8/15 surgery. I had three different PICC lines during my hospitalization...so I guess that is why I am concerned about a blood clot. The pain in my left arm has spread to my shoulder and now my neck.
doctor
Answered by Dr. Mukund Savaskar (18 hours later)
Brief Answer:
Post Sleeve Micronutrient Deficiencies causing health issues with you !!

Detailed Answer:
Brief Ans-Post Sleeve Micronutrient Deficiencies/ dehydration, causing health issues with you !!

Hi Dear !!
Thanks for your updates in your query to HCM.
I have read and reviewed facts of your updates to query in context to health complaints,resubmitted.

Suggestions-

Based on the submissions of yours,You seem to suffer from Post- Sleeve
i-deficiencies of -micro-nutrients like Magnesium,Zinc and 10 fat soluble vitamins and iron/calcium /Vit B12 /Folic acid etc.

ii-Dehydration of fluids and nutrition, which is mostly causing the palpitations, tachycardia, and shortness of breath from Cardiac overloads due to iron and other deficiencies causing pernicious anemia, which needs to be ruled out by various tests under cover of your attending doctors there.
Assessment on the above lines with your attending doctors and the nutritionist would resolve these issues over next few weeks time.

-Cause of your Palpitation/ Tachycardia-rapid heart beats / and Shortness of Breath-
Thus these symptoms seem to be accompanied with ? dehydration with multiple nutritional deficiencies and pernicious anemia post-sleeve gastrectomy.
The chest pain is mostly from the medical reasons accompanied effects due to micro-nutrient deficiencies.
The shoulder pains are mostly from the diaphragm- irritation from the bloated post-sleeve stomach, which has reduced volume capacity now.

Your other complaint of burning in thigh and calf- is mostly from - Venous Thrombosis in thigh and calf, with Thiamine deficiencies causing peripheral neuropathy, which would recover with B1 supplements ,from your attending doctors there.

-What to do in such a scenario? -
As such I would suggest you to test the levels of the micronutrients from your doctors and keep Me updated on it soon to give more suggestions in that regard.

IN SHORT-
In view of the stenotic complications in your case, you need to go slow to come out of these post-operative effects.

Update More -

i-ON the exact liquid diet you are on- with details of time- schedules for the intake, to guide more on these health issues.
ii-The list of Medicines / and Vitamine supplements which are taking.
iii-Besides this You also update Me the complications which caused delayed discharge from the hospital after the Sleeve Gastrectomy in your case.


After reviewing this, I would exactly plan further suggestions on the health issues with you to suit your specific health complaints .



Hope this would resolve your anxiety and would help in planning treatment with your doctors there.

Welcome for any further query in this regard.

Please update more data as asked above, if you need more and further help.

Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS
Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Mukund Savaskar

General Surgeon

Practicing since :1978

Answered : 3606 Questions

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What causes heart palpitations and shortness of breath post gastric sleeve surgery?

Brief Answer: Post Sleeve Complications / Under Evaluation Detailed Answer: Hi, Thanks for your query to HCM. I have read and reviewed facts of your query in context to health complaints. You seem to suffer from Post- Sleeve Dumping from more intake loads. In view of the stenotic complications in your case, you need to go slow to avoid these complaints . Please update the exact liquid diet you are on- give me details with the timing schedules, to guide more on these health issues. Suggestions- Take less quantity / volume of liquid food.(instead of 3 big meals, take 5 small ones) Reduce solid content and increase liquid content in your feeds. Don't increase the quantity/Volume of liquids, even by accident. Repeat intake after first,if needed-with sufficient time interval to reduce these complaints. As you are still on liquids, this would relieve the complaints in your case. Your other complaint of burning in thigh and calf- is mostly from - Venous Thrombosis after chronic hospitalization and needs to be assessed with Color dopler study and evaluation from Vascular Surgeon there after. Hope this would resolve your anxiety and would help in planning treatment with your doctors there. Welcome for any further query in this regard. Please update more details of your diet, if you need more and further help. Dr.Savaskar M.N. XXXXXXX Surgical Specialist M.S.Genl-CVTS