Shortness of breath after surgery can be very scary and, in some cases, life-threatening. It may involve such sensations as feeling unable to take a big breath, tightness in the chest or difficulty breathing. Shortness of breath can have numerous causes, including airway blockage, lack of activity, pain or even underlying heart and lung conditions. Feeling short of breath after surgery should never be ignored.
Airway blockage may occur anywhere from the mouth to the lungs. After surgery, the mouth, tongue, vocal cords and throat can swell or muscles can go into spasm, causing narrowing of the airway and difficulty getting air into the lungs. After surgery around the neck, a hematoma -- collection of blood -- may form and place pressure on the throat, causing collapse of the airway. Occasionally, a blood clot causes airway blockage. This is most likely after surgery involving the nose or airway.
Sometimes, areas of the lung do not fully open when a person breathes in. This is called atelectasis, and it is a very common cause of shortness of breath after surgery. Atelectasis can occur for a variety of reasons, including the effects of anesthesia, inactivity after surgery and taking small breaths due to painful breathing after chest or abdominal surgery. Smokers and people with lung disease often have trouble clearing mucus after surgery, which results in atelectasis, excessive coughing and shortness of breath. If fever and rapid breathing occurs, this may indicate the development of a lung infection, such as pneumonia.
Heart, Vessels and Fluid Problems
Blood clots may develop in the veins of the legs, especially after major surgery if a person is inactive. Sometimes, the clots break off and travel to the chest, blocking blood flow to the lungs. These clots -- called pulmonary emboli -- can produce shortness of breath, chest pain and a bloody cough. A heart attack, which is most likely to occur in people with preexising heart disease, can also cause difficulty breathing. Crushing chest pain may or may not be present.
Intravenous fluids administered during surgery sometimes accumulate in the lungs, causing difficulty breathing. This is especially likely after major surgery when large amounts of fluid are received. It is also more common in people with heart failure, whose heart muscle is unable to pump the extra amount of fluid in the blood, so it backs up into the lungs.
Severe blood loss from major surgery may result in an insufficient number of red blood cells to carry oxygen throughout the body. This can lead to shortness of breath as the body tries to breathe in more oxygen. Sometimes, shortness of breath is due to air accumulating in the space outside the lung, causing compression and collapse of the lung. This air accumulation -- called a pneumothorax -- is particularly likely to occur after chest surgery or after insertion of a central line -- an intravenous tube in a large vein of the chest.
As some causes of shortness of breath after surgery are potentially life-threatening, always report any difficulty breathing after an operation to your doctor. Also seek medical attention if you notice a painful or swollen calf, as this may indicate a blood clot in the leg, which could lead to a pulmonary embolus.
- Merck Manual Professional Version: Postoperative Care
- Complications in Anesthesia; John L. Atlee
- Chest Journal: Assessing and Modifying the Risk of Postoperative Pulmonary Complications
- Chest Journal: Postoperative Pleural Effusion Following Upper Abdominal Surgery
- Chest Medicine: Essentials of Pulmonary and Critical Care Medicine; Ronald B. George, MD, Editor, et al.
- Chest Journal: Deep-Breathing Exercises Reduce Atelectasis and Improve Pulmonary Function After Coronary Artery Bypass Surgery