“Parathyroidectomy (PTX) is primarily performed to treat primary and secondary hyperparathyroidism (HPT) and has been shown to reduce cardiac risk factors, including ECG abnormalities, 2D-echo abnormalities, arrhythmias, and NT-proBNP levels Cardiac complications, though rare, can occur in patients undergoing thyroidectomy. In a US-based cohort of 3,575 patients, approximately 0.2%–0.3% developed congestive heart failure (CHF) during follow-up. A study by Kravietz et al. found that while readmission rates were lower in primary HPT (PHPT) patients (5.6%) compared to secondary HPT (SHPT) patients (19.4%), heart failure was more prevalent in PHPT patients (10.8%) compared to SHPT patients (3.9%). Additionally, patients with existing CHF undergoing PTX have a higher likelihood of readmission. Although cardiac complications are rare, they can occasionally be fatal.”

“To minimise the risk of hypotension post-PTX, thorough preoperative evaluation is essential. Identifying patients with risk factors such as resistant hypertension and uraemia allows for tailored perioperative management strategies. During surgery, careful monitoring of blood pressure and judicious use of antihypertensive medications are recommended.
Postoperatively, close monitoring of blood pressure is crucial, especially in patients with known risk factors. In cases of early-onset hypotension, supportive care with intravenous
fluids and vasopressors may be necessary. For delayed-onset hypotension, a comprehensive approach including dietary modifications, adjustment of antihypertensive medications, and possibly the use of medications that increase vascular resistance may be required.”

Pande, Arun K R et al. “Cardiac Complications Post Parathyroidectomy: A Systematic Review.” Indian journal of endocrinology and metabolism vol. 29,2 (2025): 142-152. Free Full Text