What is cardiac surgery?
Cardiac Surgery is surgery of the heart. After the operation patients will experience chest pain, shortness of breath and decreased tolerance to exercise until they have fully recovered. Physiotherapy is very important after cardiac surgery as it will enhance your recovery and promote your independence.
One may feel fatigued and sore after cardiac surgery; it is only natural. On the other hand, it seems altogether strange to think of embarking on a course of physiotherapy afterwards instead of just resting. Yet, that is just what is recommended.
Types of cardiac surgery include bypass surgeries, angioplasty, stents, heart valve replacements, and even heart transplants. Patients having all of these surgeries can benefit from physiotherapy. Patients who have other cardiac problems can use the help too; they include victims of heart attacks, heart failure, peripheral artery disease, chest pain, and cardiomyopathy.
Purpose of cardiac surgery
The purpose of cardiac surgery is to treat damage to the heart. The most common indications for heart surgery are coronary artery and valve disease. Surgery is also performed for heart transplants, rhythm disorders, and ventricular aneurysms.
Types of cardiac surgery
Common types of cardiac surgery include coronary artery bypass grafting (CABG), angioplasty, pacemakers, and valve displacement:
- CABG – uses a blood vessel (called a graft) taken from the chest, leg or arm to bypass a narrowed or blocked coronary artery.
- Angioplasty / Percutaneous Coronary Intervention (PCI) – uses a thin flexible tube which is inserted into the coronary artery to widen the narrowed vessel. A balloon at the tip of the tube is inflated at the narrowed section of artery to force it wider. A ‘stent’ (a smaller tube) is then left in place to keep the artery widened.
- Valve Replacement – involves removing the damaged valve and replacing it with an artificial valve made of either carbon fibre or human tissue.
- Pace Maker – is an electrical device which regulates the heart beat.
Reasons for Surgery
A person may have cardiac surgery if they have coronary heart disease or following a heart attack, angina and an aortic abdominal aneurysms. These cardiac problems are associated with:
- Sudden chest pain (commonly down the left arm or left side of the neck),
- Shortness of breath,
- Palpitations
- Sleep apnoea
A person may have cardiac surgery following a heart attack, angina and an aortic abdominal aneurysm.
A person is at risk of developing heart problems if they have:
- High Blood Pressure
- High Cholesterol
- Diabetes
- Obesity
- Do not exercise
- Smoke
Physiotherapy Treatment
You will benefit from physiotherapy treatment following your cardiac surgery. Physiotherapy will help you enhance your recovery by keeping you active and promoting your independence. Physiotherapy will encourage you to mobilise independently from a very early stage postoperatively. Cardiac rehabilitation after surgery will maximise your potential and help you achieve activities that were previously difficult. Physiotherapy after your operation will increase your cardiovascular fitness and sense of well being and give you a new lease of life. Physiotherapy treatment will take you through a graduated exercise program to help you increase functional abilities and include:
- Reducing anxiety
- Reducing pain
- Muscle strengthening to improve weakness
- Appropriate positioning to aid posture
- Prevention of reduced joint movements
- Increasing range of movement
- Promoting activities of daily living such as walking, climbing the stairs.
- Exercise to increase cardiovascular fitness and endurance
- Advice and support on health and diet
- Devices to help standing and walking if appropriate.
- Teaching transfers (getting in and out of a wheelchair, bed, car, shower/bath and onto and off a toilet).
- Regular chest expansion exercise to increase lung volume and remove chest secretions
- Relaxation techniques to help improve sleep
- Promoting independence
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Physiotherapy will usually begin within a couple of weeks of cardiac surgery, if not sooner. The first step is for nurses or doctors to administer a stress test to determine how much exercise one can handle. This involves walking on a treadmill or riding on a stationary bike while having one’s vital signs monitored.
When the data is gathered and analyzed, a program of physical therapy will be put into place. For safety’s sake, it is often the routine to bring cardiac surgery patients into the hospital or an outpatient clinic for their exercise at first.
Under the watchful eyes of nurses and physiotherapy personnel, cardiac surgery patients will be looked after as they perform their exercises. This way the professionals will be alerted if the cardiac surgery patient is having troublesome symptoms. The exercises done are cardiovascular exercises like walking on a treadmill or riding a stationary bike.
After the initial period of the monitored physiotherapy has passed, cardiac surgery patients will be sent to do their exercising at home. Before they go, though, they will have been taught warm-up and stretching exercises, and when to stop. Generally, they should exercise three to five times a week unless they are having problems.
Swimming is another form of exercise that is especially good for cardiac surgery patients. It is a cardiovascular exercise that is not hard on the joints, so it will often be kept up longer. The only thing to remember is that all wounds must be completely healed first.
Physiotherapy for cardiac surgery patients is often not only carried out by physiotherapy staff. Nurses in hospitals and clinics who are trained to deal with these areas of rehabilitation for cardiac surgery will do the work. However, cardiac physiotherapists also help, and the principles are the same.
The physiotherapist will instruct the patient about what activities are acceptable in the weeks and months after surgery. During the first six weeks, there will only be a few activities allowed, such as light housekeeping or going to movies, for example. From then until the third month, more activities will be added. You may be able to return to work, at least part-time, you may be able to drive. After this time, your physiotherapist will work with you to ease you back into all your old activities.
If a patient has cardiac surgery and then does nothing to regain strength, that patient will soon weaken. Physiotherapy offers a means to stay in shape, or get into shape. It lends more purpose to the cardiac surgery by making the patient much healthier than before the surgery ever took place.
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