Chest Discomfort After Bypass Surgery: What You Need to Know

What is Bypass Surgery?

The procedure known as Coronary Artery Bypass Grafting (CABG) or Bypass Surgery involves inserting an arterial graft that circumvents the blockage in order to open up arteries that have been obstructed due to plaque accumulation.

Causes of Chest Discomfort After Bypass Surgery

According to research, patients who have had CABG surgery frequently suffer a variety of symptoms, including Chest Discomfort After Bypass Surgery.  The causes include:

1. Postoperative pain due to chest tubes that were inserted, respiratory difficulties, arrhythmia, palpitations, anxiety related to treatment, edema (swelling) at chest incisions, etc are all possible causes of Chest Discomfort After Bypass Surgery.
2. Other rare causes of Chest Discomfort After Bypass Surgery include Diaphragmatic paralysis due to phrenic nerve paralysis and early graft failure.

Types of Chest Pain You Might Experience

Chest pain after CABG can be of several types depending on the reason for pain:

1. Hypersensitivity at the chest surgical site, which can cause even a light touch to feel extremely painful
2. Soreness at the chest which may feel like a brief, poking pain which may be due to wound healing or swelling 
3. Muscle stiffness of the chest which may feel like you are wearing a tight coat 
4. Musculoskeletal pain, which occurs because the muscles of the chest were incised during surgery, can be a dull or sharp pain and increases with movement. 
5. Central chest pain, which is burning in nature, at night or after eating/ alcohol consumption due to gastroesophageal reflux
6. Sternal instability or instability of the sternal wire with a sharp pain localised to the surgical site
7. Respiratory disease which manifests as sharp pain, usually with deep breathing along with shortness of breath, which indicates respiratory infection 

When is Chest Pain Normal During Recovery?

Up to 80% of patients report Chest Discomfort After Bypass Surgery or postoperative chest pain, which is the most common symptom, particularly in the first month following surgery. This could occur due to the reasons mentioned above.

Normal vs. Concerning Chest Discomfort: How to Identify

Chest pain after CABG can be extremely worrying for the patients, which is why it is important to know when chest discomfort after Bypass surgery should be of concern. 

Normal Chest Discomfort After Bypass Surgery is characterized by persistent pain after surgery with normal findings on assessment and investigations. A musculoskeletal cause or persistent postoperative discomfort, which is common following bypass surgery, could be the source of this.

Here’s how to identify Concerning Chest Discomfort After Bypass Surgery:

1. Is the chest pain of sudden onset or of increasing severity or radiating to the back? This may be due to ischaemic heart disease or aortic dissection.
2. Is the pain is localised to the surgical scar and is accompanied by discharge at the site and fever? Suspect sternal wound infection
3. Is there a Shortness of breath? This can indicate underlying respiratory pathology along with other signs of infection, suggesting pneumonia.

In order to discuss your pain issues, you should always call your doctor if your pain is not getting better or if you are worried about it getting worse.

Tips for Managing Chest Discomfort at Home

1. It can be beneficial to wear loose, comfortable clothing that doesn’t press against your wounds. 
2. During the healing process, keep the wounds clean and shield them from the sun. 
3. Higher levels of postoperative pain have been associated with stress and anxiety. Thus, maintain your composure and ease! 
4. Maintain a healthy lifestyle by abstaining from alcohol and tobacco, eating complete, healthful foods, and getting occasional movement into your schedule.

How to Treat Chest Pain After Bypass Surgery?

1. Painkillers: Your doctor may recommend painkillers to assist you in managing your chest discomfort after bypass surgery. Before you do any strenuous exercise or before the pain gets too bad, take your medicines. To make sure you’re comfortable, your doctor will periodically evaluate your postoperative pain medication schedule.

2. Prevent infections around incisions: An open wound can become contaminated by microorganisms. As a result, patients need to keep the wound dry and use an antibacterial to gently clean it. Following bypass surgery, chest pain could intensify due to surgical site infections.

3. Vests and bras for surgery: For comfort, women may choose to wear surgical bras. When lying down, the weight of the breasts frequently pulls on the incision site. That discomfort is lessened with the surgical bra. A surgical garment may provide greater incision support for heavier men.

4. Relaxation or guided imagery: This technique employs the imagination to assist the body relax by imagining tranquil or pleasant sights to encourage comfort and serenity. Yoga or simply gentle breathing techniques might help you relax.

5. Perform your physical activity gradually. At first, avoid standing for longer than ten minutes and avoid carrying heavy objects. After bypass surgery, excessive physical activity might exacerbate chest pain.

6. Be optimistic: Having a positive outlook is crucial for overcoming any serious health issues, including after Bypass surgery.

What are the precautions to follow after bypass surgery?

1. Activity precautions: During your recuperation, your physician may suggest some activities that you should refrain from. Typically, you can engage in mild activities like short walks in the initial days following your hospital discharge. Preparing food playing board and card games raising objects that are light 

2. Exercise precautions: Avoid working out outside in extremely hot or cold weather. If you experience any chest pain, lightheadedness, or shortness of breath, stop. Avoid any workout or activity that pulls or hurts your chest, such lifting weights or using a rowing machine. Nothing larger than 5 to 7 pounds (2 to 3 kg) should be lifted. 

3. Skin precautions: Keep the tissues around your surgical incision shielded from the sun to avoid sunburn. Also avoid tight clothing which may irritate the surgical site.

Conclusion

Bypass Surgery is a life-saving procedure that improves a patient’s quality of life after heart disease. Chest discomfort after Bypass surgery can happen due to many reasons and is part of normal recovery in the absence of major complications. 
If you have any queries regarding Chest discomfort after Bypass surgery, you may book a consultation with Dr. Nikhil P.J.Theckumparampil, Heart Specialist & Cardiac-Surgeon, at Heart360 Care.

Frequently Asked Questions