Question:My husband had a total hip replacement last month. He also had a heart attack about two weeks later. We didn't even know it was happening until it was all over. We thought his symptoms of weakness, fatigue, and restlessness were part of his recovery. Does this happen very often? Shouldn't patients be told ahead of time to watch out for this?
Answer:Many patients getting a total hip or total knee replacement are older adults with other health problems. When a patient has more than one condition, disease, or illness, these additional problems are called comorbidities. High blood pressure, diabetes, or heart disease are just a few examples of comorbidities. Physicians are encouraged to assess all surgical patients for current health concerns and risk factors that might become a problem after surgery. Comorbidities such as diabetes and heart disease are often risk factors.
The risk of heart attack after total hip replacement increases with age. Adults 80 years old or older have the highest risk. Other risk factors such as smoking, physical inactivity, and obesity should also be noted.
Matching potential complications with signs and symptoms experienced by the patient or observed by the family is important. There are many risk factors for heart attack. These may include smoking, high blood pressure, high cholesterol levels, physical inactivity, and obesity.
Postoperative complications after major joint replacement (hip or knee) are most likely to occur in the first 30 to 90 days. Patients and their families are usually given information after surgery about what to watch for. Doctors are especially concerned about local infection, pneumonia, and blood clots.
Under the stress of an upcoming surgical procedure, patients don't always remember what they were told. And sometimes the symptoms of a heart attack are silent or so mild the patient doesn't realize what's happening.Daniel T. Alfonso, MD, et al. Nonsurgical Complications After Total Hip and Knee Arthroplasty. In The American Journal of Orthopedics. November 2006. Vol. 35. No. 11. Pp. 503-511.
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