Continuing on with a topic I ended 2015 on, Postperfusion “Pumphead” syndrome,
memory loss and cognitive issues after open heart surgery.
I recently came across a blog on the internet called “Rehabilitate the Heart” which I felt
is very relevant to those of us who have had open heart surgery and more
importantly, an article that has relevance to those close to us including spouses,
partners and children.
And given this question of memory loss comes up so often in social media "heart" groups such as Facebook and in cardiac rehab programmes I feel another post on this topic is more than appropriate.
This blog not only continues on with the discussion
regarding postperfusion syndrome but also introduces the question of Vascular Dementia.
******************
"Working in Cardiac Rehabilitation it wasn’t
uncommon for a spouse or significant other to come in with the patient on the
first day or early on in their rehabilitation and voice concern about the patients memory. It is common during the first three
months after open heart surgery to be forgetful, to not remember little things,
to be frustrated easily. However, within three months these issues should
improve. There are a number of people however who have a steady decline in what
we call cognitive health or show cognitive impairment. They begin to
display progress symptoms of dementia. This is very real and it is very scary,
for both the patient and the caregiver.
Two common reasons for the mental
decline are Pump Head and Vascular Dementia
Postperfusion syndrome, also known as “pumphead” is an impairment of cognitive symptoms
attributed to Open Heart Surgery. Symptoms of postperfusion syndrome are
subtle and include defects associated with attention, concentration, short term
memory, fine motor function, and speed of mental and motor
responses. Studies have shown a high incidence of these issues soon after
surgery, but the deficits are often short lived with no permanent damage and
last only a few months. It is when the symptoms persist beyond the first few
months are concerning.
The
symptoms of pumphead include:
·
difficulty
in concentrating
·
increased
depression
·
short
term memory deficit
·
slower
speed of mental and motor responses
“Pumphead” refers to the state in which
patients seem to linger after being hooked up to a heart-lung machine for
open-heart or valve surgery. The clinical term for pumphead is
cognitive impairment after coronary artery bypass grafting (CABG). Other symptoms include poor recall, social
difficulties and personality changes. Pumphead
is when after an initial recovery of mental capabilities in the first few
months, the condition often worsens later and persists for years.
Cognitive training may improve memory and reasoning
in patients after CABG
Thus
the new area of rehabilitation, cognitive rehabilitation, such as after an
acute injury to the brain like a closed head injury or a stroke.
"A
new study results confirm that older adults who undergo CABG experience
postoperative cognitive decline but show that cognitive training improves
memory and attention, suggesting that this training can be a useful
rehabilitation tool.
Cognitive
training is a “burgeoning business,” much of which involves computer-based
puzzles and brain games. While there’s a lot of suggestive evidence of an
association between mental stimulation and lower risk for dementia, “we need to
do more science around it to find out what works and what doesn’t work,”
http://www.theheart.org/article/1454099.do
Is it Pump Head or Vascular Dementia?
Inadequate
blood flow can damage and eventually kill cells anywhere in the body. The brain
has one of the body’s richest networks of blood vessels and is especially
vulnerable.
In vascular dementia,
changes in thinking skills sometimes occur suddenly following strokes that
block major brain blood vessels. Thinking problems also may begin as mild
changes that worsen gradually as a result of multiple minor strokes or other
conditions that affect smaller blood vessels, leading to cumulative damage. A
growing number of experts prefer the term “vascular cognitive impairment (VCI)”
to “vascular dementia” because they feel it better expresses the concept that
vascular thinking changes can range from mild to severe.
Vascular brain changes often coexist with changes linked
to other types of dementia, including Alzheimer’s disease."
