For every pound of fat, there is a mile of blood vessels, according to Dr. Terry Simpson. All of these blood vessels mean the heart has to pump harder to get the blood flowing, putting more strain on the heart. For bariatric patients, this means we need to get a clearance from a cardiologist before surgery. Every program is different, and your program may not require cardiac clearance. You may want to get evaluated anyway, just in case of any underlying issues, They’ll likely do an EKG in the office and discuss your medical history. The doctor may order further testing to evaluate your heart more thoroughly. The cardiac clearance for bariatric surgery includes an EKG, a review of your personal and family’s medical histories and an evaluation.
Why Do We Need a Cardiac Clearance for Bariatric Surgery?
Many bariatric surgery programs require a cardiac clearance before surgery. I think it should be required of every program simply because you never know what underlying heart condition you may have. I’m not saying there’s something wrong with your heart, but even minor surgery puts a strain on your heart. It’s best to get it checked just to be sure there are no issues before surgery.
Dr. Terry Simpson at YourDoctorsOrders states that surgeries do put a strain on your heart. Getting a cardiac evaluation gives the surgeon information prior to surgery if something goes wrong during the procedure. He also states the most common reason for sudden cardiac arrest in obese people is thickened heart muscle. By getting a cardiac evaluation, your doctor will be able to learn whether your heart muscle has thickened and to resolve the issues before surgery to reduce the risk of death and disease.
As part of the cardiac evaluation, a cardiologist may order further testing to rule out any issues. Dr. Simpson states that some of the additional testings may include a cardiac CAT scan, a stress test, a nuclear stress test, an angiogram or an echocardiogram. Each of these tests allows the doctor to get clearer information about the structure and function of the heart. The cardiac clearance for bariatric surgery may require you to get one of these tests.
Getting an EKG
A cardiac clearance for bariatric surgery may start with getting an EKG. An EKG, sometimes referred to as an ECG, is an electrocardiogram and records the electrical activity of the heart. An EKG measures the heart, heartbeats and whether there is damage to the heart.
The technician will attach stickers to your chest and arms. Wires are then hooked up to the stickers and the test begins. It takes only a few seconds, and it takes longer to attach the stickers to your chest than it does for the test. It’s painless, you won’t feel anything during the test, but may experience irritation when the stickers are removed. After the test completes, the report prints and the technician removes the wires and stickers.
Reviewing Medical Histories
Next at your cardiac clearance for bariatric surgery, the doctor may review your personal and family medical histories. He or she will want to know if you ever experience chest pain, shortness of breath or heart palpitations. They will ask if you have other medical issues, such as high blood pressure, diabetes, sleep apnea or thyroid issues. Prepare to provide the doctor with a list of all your current health conditions and medications. The cardiologist wants to get an overall picture of your health, so that he or she knows how to proceed.
The cardiologist will also discuss your family medical history. Many times, cardiac conditions can be hereditary, so knowing your family’s medical history can paint a clearer picture for the cardiologist. Prepare to answer questions about the health conditions of your parents, siblings, grandparents and even aunts and uncles. If any have died, they may also want to know the ages at their death and what was their cause of death. Finding this information beforehand can make the appointment run a lot smoother.
The Cardiac Evaluation
Once your doctor has all the information he needs, including your current EKG, medical history and family medical history, he will perform an exam. He’ll likely listen to your heart using a stethoscope and check your blood pressure. They may check your heart rate and oxygen saturation as well. All of this information will help the doctor determine his next steps.
He or she may clear you for surgery right away. If so, that’s great! However, he or she may want to do some further testing as a baseline and to rule out any unknown cardiac issues. If this happens, don’t worry. Your doctor just wants to be thorough so that if there are any issues, they can be resolved before surgery.
My Cardiac Clearance for Bariatric Surgery
At my cardiac clearance for bariatric surgery, it started just as I described above. I had an EKG, which does take longer to attach and remove the stickers than for the test itself. Afterward, the doctor discussed my current medical conditions and my family’s medical history. I told him that I get shortness of breath when I exercise, have a history of high blood pressure, experience acid reflux and have a fatty liver.
I told him that my grandmother died of cardiac arrest, and so he ordered a transthoracic echocardiogram as a baseline and to make sure there were no issues with my heart. He also suggested my goal weight be 200 pounds, and I told him that if I ever get that low, I’d have to push and get below 200 (fun fact – as I’m writing this post, I weigh 194 pounds).
What is an Echocardiogram?
An echocardiogram is a diagnostic test that uses ultrasound to check the structure and function of the heart. At my echocardiogram, the technologist reviewed my medical history to get an idea of what to look for on the ultrasound. I then changed into a hospital gown and laid on my side. She rubbed an ultrasound probe over my heart to check blood flow through valves. She also measured my ventricles and valves. The test takes about 30 to 45 minutes and is relatively painless. I did feel pressure at times when she had to press the probe into my chest, but it wasn’t too bad.
Thankfully, my echo came back normal, and my cardiologist cleared me for bariatric surgery. If you need an echo and they find an issue, it doesn’t mean you’re necessarily disqualified from surgery. Discuss it with your cardiologist and bariatric surgeon to see what needs to be done. You may just need additional treatment before your bariatric surgery.
The Cardiac Clearance for Bariatric Surgery
When you’re obese and have lots of fat, you have lots of blood vessels. Therefore, your heart has to work harder to keep blood pumping throughout your body. Your bariatric surgeon may recommend a cardiac clearance for bariatric surgery. This clearance includes an EKG, a review of your personal and family medical histories, an evaluation and possibly further testing. The cardiac clearance is nothing to fear. It’s an essential step in the weight loss surgery process. Knowing before surgery if you have any cardiovascular issues allows your surgeon to better treat you. My cardiologist experience was generally positive, and I’m glad I had peace of mind going into surgery that my heart was OK. Don’t procrastinate getting your cardiac clearance. The sooner you get it, the sooner you’re on your way to bariatric surgery and changing your life.
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At the cardiac clearance for bariatric surgery, you’ll likely receive an EKG in the office to check the electrical activity of your heart. Next, your doctor will review your current and family medical histories to see what risk factors you may have for any heart-related diseases. The doctor will listen to your heart, check your blood pressure and check your oxygen saturation. Based on these findings, he or she may recommend further testing, like a stress test or an echocardiogram. Afterward, if there are any issues, the doctor will help treat you before your bariatric surgery.