Emotional And Behavioral Changes After Heart Surgery… For Beth & Erik

Beth just emailed me about her husband’s problematic recovery from heart surgery. She writes, “Hi Adam – My husband had heart valve replacement surgery (from mitral valve prolapse with regurgitation) two months ago. Since then, he seems to be experiencing some emotional and behavioral changes after heart surgery. Although his heart is doing great, Erik seems to be “a little down” and somewhat “out of it” since the heart surgery. Any thoughts? Thanks, Beth.”

Here are my thoughts for Beth:

As patients, we enter the operating room with two critical thoughts. The first thought is, “Please let me live!” The second thought is “Please fix my heart so that I can live longer!”

After surgery, the relief of living and having fixed hearts is not enough for many patients. Instead, many patients are bombarded by difficult thoughts relative to pain, complications and ultimately, a challenged recovery. That said, these thoughts can manifest in emotional and behavioral changes after heart surgery.

In my own research, I learned that 30%-75% of patients report feeling anxious or depressed after heart surgery. That’s a pretty significant number. Personally, I experienced both emotional and behavioral changes following my valve replacements. I was moody. I was irritable. I was fatigued. I was tired of the pain.

As Doctor R. Scott Mitchell notes, “I think the cause of cardiac depression is entirely unknown… But, it could be the psychological effect of anticipating surgery, the prolonged time under anesthesia, or the results of the heart-lung machine.”

On this note, reports suggest that these emotional and behavioral shifts are increasing in frequency. In the opinion of many, this increase is directly related to short hospital stays in which patients are discharged too quickly after the operation. Today, patients are in the hospital five days on average. In the past, patients would have ten to fifteen days in the hospital to assimilate their new reality, according to Dr. Richard Fogoros.

As to what can be done about the emotional changes after heart surgery, I took several guided steps including attending cardiac rehab classes, spending less time alone, ending my use of Vicodin, etc.

Cardiac Rehab Program - Torrance Memorial Hospital
Adam In Cardiac Rehab Class

I hope this helps explain a little more about the common emotional and behavioral changes after heart valve replacement surgery and heart valve repair surgery. Scroll down to see over 45 patient comments.

Keep on tickin!

Adam Pick
Written by Adam Pick

Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of HeartValveSurgery.com.

To learn how Adam has helped millions of people with heart valve disease, watch Adam's video, subscribe to his free newsletter, or visit his Facebook, or Twitter pages.

  • Carmen

    I had a double by-pass surgery in December and the surgery so far as be fine but I have experienced lots of pain and cognitive problems my remembering thing is very hard at this time. Has anyone experienced this problem I am 48years old I should not be experiencing memory loss at this rate. Any comments

  • vj

    My husband had a triple bypass and mitral valve repair almost a year ago. He has always been plagued by anxiety and depression..probably led to his heart attack six years ago. He is retired, has few friends, no hobbies and spends much of his day online and watching TV. What a life. After 40 years of marriage and four children, I am feeling very conflicted. Fortunately I am very well. Fortunately, for him, I have a strong ethic and sense of loyalty to him. I take good care of him. But he has not been a good patient as far as post operative rehab is concerned. Refused to go to any physical rehab or any of the counselling sessions that were offered. So his recovery was slow, however it turned out good, physically. His behaviour is normal in many ways but bizarre in others. He has become ultra-religious, wears shabby but clean clothes, has given away all his dress shirts, suits, dress shoes, has grown a long beard (his cardiologist saw that as a sign), looks like a street person. Needless to say, I am not thrilled to be seen with him, open-minded and patient though I am. I think I have reached my limit. We are both educated and well-travelled. Life was pretty good. No longer for me. I hate to sound so selfish, but the future does not seem bright. Can all this surgery be the cause of dementia? I would appreciate any insight on our plight. Thank you for all your comments on this forum. God bless you all and give you strength.

  • Sherrie

    Hi my name is sherrie. My husband, Tim, age 36, just had a triple bypass on Aug. 16, 2013 he’s only been home a few days. (Hosp. Stay was days ) he was determined to get up and walk so he could go home. Now that he’s home… Well, it’s not the same… He doesn’t wanna do the things he’s allowed to do.He only wants ta do what he’s not suppose ta do… If he’s not doing what he wants, little things, now big things then he’s on the couch or bed refusing to do anything… Even talk. I keep telling our kids and myself that, I know things r different right now but u have to remember daddy hurts. He can’t do all the things dads r suppose to do right now so he’s upset but it’ll b ok. Give daddy time to heal…. I need some help. We need help. I can’t fix this for him. I can’t make it go away, but no matter what I say or do I can’t reach him. What can I do so he knows I’m here, we’re here and we love him. How do we get pass this? Will it get any better 4 him, 4 us?

  • Diane

    This sounds over the top for this kind of surgery. this surgery certainly causes depression and it does get better. It is so difficult to deal with depression especially for the family, but I would definitely talk to his doctor. All I wanted after surgery was to go home and I know I pressured my doc to let me out. Once home I was scared of every heart beat and assumed everything was going wrong. Also it is difficult to get good REM sleep because of limited movement and that makes depression worse. It got better and better for me but I did not spend my day in bed. I always got up and dressed. He needs some gentle intervention to let him know that soon he will good as new, and even better. Hope this helps.

  • Frank

    My wife (68) had mitral valve repair 3 months ago. Her recovery is on track; she is walking longer distances each day, eating normally, and in PT. Physically she is making progress. However, she has died emotionally towards me, shows no affection, is content to spend a lot of time alone, and can’t seem to speak to me without being condescending. Her female friends rave about what a caring, compassionate person she is.

    I have been supportive to a fault, gentile, compassionate, helpful and understanding. Nothing works. We have been married 44 years, and I am beginning to wonder if we’ll make it to 45. Someone please help; your counsel and comments are needed, welcome and apprciated.

  • vj

    Three months is still fairly early into recovery for your wife. It sounds as if she is being compliant, doing her PT and walking. She is probably just weaning off a lot of the heart drugs. I think it takes several months to flush out all the drug residues that have accumulated in the body. We were told that full recovery takes a whole year. My husband just passed the one year mark last week and I am glad to report that life is returning to normal. Or maybe I have adjusted to the new normal. In any case, things are much better than they were in July. I think my husband is feeling much better and his confidence is back. Perhaps that one year mark is a psychological hurdle that has to be overcome. He is once more an affectionate and considerate person. Even helpful around the house without too much prompting. I admit that I took off the kid gloves and had it out with him a few times. Not my finest moment, but perhaps necessary as a wake-up for him. I hate to say that more patience might be in order while your wife recovers, but give her that year. You have been married for 44. I hope things continue to improve for the both of you. It is hard for you, too, I know. God bless you both.

  • William Smith

    I had my mitral valve replaced in 2005. Within a few weeks of having the surgery, I was well enough (physically) to go outside and mow my lawn. It’s the emotional component with which I am having difficulty. I felt that I had been given a “new lease on life” and, for the first time in my marriage, considered having an extra-marital affair, going so far as to join several disreputable dating sites. No sexual liaisons occurred, mostly because most of these women (I am convinced) are really Nigerian men pretending to be women. But that’s a different story. What is more problematical is the fact that, after the surgery, I completely lost control over my temper. This has already cost me three jobs.

    So, there you have it. I honestly believe that, if I had known that having my mitral valve replaced was going to cost me the love of my family and three jobs, I would have refused the surgery, just for the honor of dying the same moral and ethical man I had been up until that time.

  • cheryl

    I am a 54 yr old, I had aortic valve replacement – artificial valve and acsending aorta replacement on March 1, 2012. I had stenosis from chemo and radiation to treat cancer 34 yrs ago and was told that after surgery I would have a new lease on life. Well it has been almost a full yr and I am still experiencing “stuff”. Physically things are better but lately I have felt like something is missing as though I lost part of myself during surgery! My eye site has changed, focussing on anything long term is tuff, reading is something I love but doing it like I use to is hard. I forget words I want to say when I am speaking, very irritating. I just feel off for the past yr. After reading this blog I know I am not going nuts! Thank you! I walk 5 miles almost every day, do some kind of muscle strengthening daily, so I am active. I lost my job due to having surgery so I know that is part of the self esteem issues, work gives you purpose. But I just feel lost.

  • Pam

    Thank you for this blog. I’m relieved to see I’m not alone. I’ve been experiencing sadness, frustration and fear that I will not be the same again after Aortic valve replacement. I don’t really care to do anything and then I get feeling lonely.
    I am very worried that I will become a burden on my family and a bother to friends who have been so helpful to me. I had a scare on the 9th day after surgery when I awoke with my heart racing. It didn’t make sense to me that my heart would be racing if I was sleeping so I called a neighbor and she took me to the emergency room. I hated that (bothering people needlessly). I didn’t get any answers as to why but was told that sometimes the heart gets out of rhythm and that this would probably not happen very often..GEEZ…I can’t stand all this drama over something I should have been able to manage on my own and yet I can’t!!!

  • Gene

    it’s been2 years so I had quadruple bypass, then a infection another surgery, wound care tore a veins then a 3rd surgery. I have major lack of support enthusiasm or joy. 58 years old, lost my business. Every one says i should be happy i lived but me.

  • rex

    I had bypass completed 4 weeks ago. It went well, only had to stay in the Hospital for 4 days. I am 50 and guess I did well due to my age. I feel that I am getting better physically every day. Emotionally I am a mess. I feel violated, less than a human now, I almost feel like I should not have lived through the surgery. The doctors tell me that I am lucky and refer to the problem area as the widow maker. Pretty much let me know if I had not caught this then I would have died this year. They chuckle and seem to play it off as just another day at the office, tell me to keep up the good work and they will see me in 3 months. I go through the motions, tell my family I am doing fine, but again, mentally I just can’t seem to put it completely into words on how I am feeling. I just don’t see a future for myself. I am not suicidal at all, I just see no purpose for continuing. I hope this all passes. Before this all came up out of the blue, I really enjoyed life, wanted to live forever. I use to joke with people about how I wanted to see all life had to offer. Now I don’t

  • Zoe

    I am 18 and sixteen days ago,I had open heart surgery to repair several holes and a valve. Due to complications, I was taken back into surgery (totaling 10 hours under general anesthetic) and spent 3 days in intensive care. I was on a ward for 4 days before being discharged. I am aware that everyone is different and recovery periods vary however I worry my pace is much slower than it should be. I am now at home and am very emotional, have a major lack of motivation and am sill taking many pain killers and sleeping a lot. Can anyone reassure me or advise me of things that may help?? Thanks.

  • Cheryl

    Dear Zoe I had open heart one year ago. I was in ICU for 3 days and released five days later only to have to go back in 24 hours after I got home due to fluid. I am doing so much better one year later but I so get the emotional sadness and feelings of loss. I took myself off of the pain meds bc they seemed to increase my feelings and gave me really vivid crazy dreams. I will say that forcing yourself to walk, shower, get dressed and do any thing that is normal stuff helps. I could only walk a flat surface so I walked inside around the house first ten minutes twice a day working slowly to thirty I now walk 4 miles a day. I had cancer when I was your age and the treatments produced a lot of scar tissue on my valves so I now have a mechanical valve – very noisy! Keep pushing forward it takes time and I would do the cardiac rehab if u can it helps a lot w learning to trust and believe in yourself.

  • Diane

    When I had heart surgery in 2001 the discomfort I remember the most was my depression. That was worse than any pain I might have had. It took a few weeks to finally get over it so hang on, it will get better. It seems to be a constant with open heart surgery. It would have been wonderful it the doctors and nurses had realized that this is common and given some encouragement. In fact I am surprised that that wasn’t the case. This side-effect should be told to every patient so they know what to expect. It did help once I was able to sleep flat in bed on my side or belly. Before that I was so sleep deprived. Get as active as you can. Keep pushing yourself and get outside.

  • Jolene

    Hi My husband has to go for a triple heart bypass in the next to weeks we have been married for 17years him been 59years old me been 38years old. All I can think about is how scared I am and how am I going to do this. Did I mention that I have four children 15-13-11-10 any information that you could give me in how to prepare my home for after the op would really help thanks

  • Kyle

    My dad 76 just had triple bypass over a week ago and had to go back on the table to remove fluid. He will be discharged tomorrow after 8 days in icu. He has trouble sleeping and is very combative and uncooperative. He is disoriented and is not himself. He is giving the nurses a very hard time and drs say he will return to normal in a few days. This is so out of character for him to act this way, I understand what he just went through. But after reading alot of the blogs, im worried he may never return to normal. And my eldery mother may not be able to handle his after care plus his mental changes. Before sugery he was a very active man even though he was 76, and such an independent person. It is hard to see him like this, I hope he can return to normal like the dr says…..it wouldve been nice if they would have counseled us on the after effects of surgery.

  • Louise

    Wow! I thought my husband was the only one going through the “blues” and having no energy or interest in life. He has always been so kind & caring till his surgery in June 2014. It’s been 4 weeks and I swear they sent the wrong patient home. He tells people he’s doing well, but I know him so well after being married 45 years, I know he’s going through some hard times. He is not the person I married. He blames everything on me. Nothing is good enough: ” His pills are too big, the glass of water is too full, he tells me to leave him alone cause I’m not a nurse”. He won’t talk to me and very grouchy! We have always been able to talk to each other and tell it like it is, but I don’t dare anymore. He is definitely very very different since his aortic valve repl. Thank you for letting me know that I am not alone.

  • Doris

    I had aortic valve replacement surgery January 17, 2014. At six months, I am still learning what to expect at each stage of the game. My energy level is greatly increased, although there are times when I feel as if I am having an energy surge. If I do too many things, I feel drained after a little while.

    Last month, my cardiologist approved a road trip me, cautioning my family that I would need to get out of the car every two hours to walk around, in order to avoid the posibility of developing blood clots. Although there were three drivers, when it was my turn to drive, my sisters allowed me less driving time than either of them, because I, while they were driving, kept falling asleep.

    One of my prescriptions states that I need to stay out of direct sunglight as much as possible. While we were outside, I wore a hat, and avoided sunlight as best I could. However, I still encountered problems. After we returned, I caught a bad cold, that included a deep, hard cough. It cleared up after a few days. Since I did/do not know what is safe for me to use, I sucked on cough drops, and took Zyrtec.

    I still get sleepy at odd times. I also, feel sensations of burning, itching, sometimes an occasional jab in various parts of my chest. It usually passes quickly, especially when I use antacid tablets..
    My next appointment with the doctor is in November.
    Is there cause for concern, or can I wait until I see my cardiologist, keeping to my scheduled visits?

  • Karen

    I was 43 yrs old when I had my mitral valve repaired. I was in the hospital for ten days due to my blood pressure being so low. I was out of work for three months. My incision hurt so much without any infection. I could barely have anything touching it let alone wear a bra. Life for a yr was miserable after that. The scar was very unsightly as it looked like I had a bullet wound. It was suggested I see a plastic surgeon. He was able to remove some of the wires at each end of my chest. That was the answer. Once that healed the pain was almost nonexistent. Once I was able to sleep the night it made a huge difference.

  • William mulcare

    I am 38 and have had 4 heart valve surgeries, I have experienced discrimination and had to find new jobs due to lack of confidence from bosses thinking I cannot perform my job. I also have no college degree which limits my options and have been forced to work hard physical jobs not mentioning my condition. I have talked to doctors and professionals who think im lying or suggest I get legal help but this is the real world and us heart surgery survivors get depressed and no pill will fix that. Imagine having your chest opened and not ever function the same ever again…its depressing and unfair…

  • http://www.HeartValveSurgery.com/ Adam

    William – So sorry to hear what you have been through. My thoughts and prayers are with you. Adam

  • Doc Retired

    Dear Adam: If you are collecting anecdotal evidence of personality changes and serious psychiatric problems post open heart surgery, I would be glad to contribute my experiences. Seems those of us who are the family members need you to write a book to and for us.

  • http://www.HeartValveSurgery.com/ Adam

    Very appropriate point Doc Retired! Heart surgery is tough for all involved – the patient, their families and friends.

  • jeff

    I had mitral repair seven months ago.I have tried four different antidepressants, the side effects being intolerable. These meds may be a bridge to a time I do not need that kind of help. Thirty years of mitral prolapse anxiety and pain has given me some patience. It is just a different kind of pain, the depression and the unexpected severity of working memory loss. The things that have worked for me guided meditation, acupuncture, reading and telling jokes, and stories/lectures that kindle hope. I tried memory games like Lumosity offers but they only lowered my confidence and seemed to aggrevate the sensation of inflammation in my head. I needed to admit I had to drastically reduce my stress level.I have had to find new sources of enjoyment to replace activities I can no longer do. I have not too successful finding things to do that don’t overwhelm me after a little while. I am getting better at telling jokes and laughter seems like the best way ease the mental/emotional strain.

    What seems like brain damage has not really improved since the procedure and is distinct from the depression. My ability to hold many ideas or images in my mind simultaneously is severely reduced. It is though I perceive the world now in two dimensions. The sense of spiritual loss, of separateness, is the worst.

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