Coronary Bypass Recovery: What to Expect

Practical tips after coronary bypass surgery

If someone's doctor informs him that his coronary arteries (the arteries that provide blood flow to the heart) are severely blocked, he may need to undergo coronary bypass surgery. Also known as coronary artery bypass grafting, this surgical procedure diverts blood flow around a section of blocked or diseased artery. According to the American Heart Association, more than half a million of these operations are performed every year.

Bypass surgery is a major operation: The surgeon usually makes an incision along the breastbone (sternum), spreads the rib cage, stops the heart, and uses a heart-lung machine to circulate the blood during the operation. In some cases, the surgeon may remove a section of a long vein from the leg and use it as a bypass graft.

In this procedure, one end of the leg vein is grafted to the aorta (the large artery leaving the heart), and the other end is grafted to the coronary artery past the blockage. Alternatively, the surgeon may detach one or both of the internal mammary arteries (arteries that branch from the aorta) from the chest wall and attach the open end directly to the coronary artery downstream of the blockage.

Recovery from coronary bypass surgery depends on a number of things, including what type of bypass was done, the patient's physical condition before the operation, and whether he complies with his doctor's recommendations following surgery. A general timetable may help you plan for the future, but remember that there's no set schedule for recovery. Whether the patient experiences some or all of the following issues, here are some practical tips to help you both.

Physical issues after coronary bypass surgery

Loss of appetite or constipation

What you can expect: It may take several weeks for a patient's appetite to return to normal. He may complain of nausea at the smell of food for a few weeks after the surgery. Constipation can also be a problem, and he should avoid straining on the toilet because it can elevate blood pressure and stress the heart.

What you can do:

  • Offer frequent, small meals instead of three large meals a day.

  • Ask him what foods are the most appealing.

  • Try bland foods with a soft consistency, like applesauce or oatmeal. Steer clear of spicy foods or those with a strong taste or smell.

  • To relieve constipation, offer lots of fluids and foods high in fiber. Prune juice contains a natural laxative.

  • Ask the doctor if the patient can take an over-the-counter laxative or stool softener.

Weakness, fatigue, and shortness of breath

What you can expect: Nearly all patients recovering from bypass surgery will experience weakness, fatigue, and shortness of breath.

What you can do:

  • As soon as you get the doctor's okay, encourage the patient to get moving. Just getting out of bed, taking a shower, and dressing may be exhausting at first. In the first week, he should begin walking for five minutes, five times a day. Although this won't seem like much activity to you, it can be very difficult for him. Acknowledge that he's having a hard time while encouraging him to continue. After a few days, you should notice a significant improvement in fatigue and shortness of breath.

  • Be patient, and encourage him to do the same. He's just been through a major ordeal and you should both expect recovery to take time.

  • Within a few weeks, he should be able to begin a modified exercise program. If he has always been fairly sedentary, he may resist this idea. You might motivate him to exercise by:

    • Helping him set specific, realistic goals.

    • Exercising with him.

    • Keeping a journal of his progress.

    • Getting him moving first thing in the morning.

    • Helping him find exercise he likes to do -- for instance, if he hates walking, ask him if he'd enjoy a swim instead.

  • Recognize that it's not all up to you. You can encourage him to exercise, but ultimately he'll have to decide he wants to do it.

Leg swelling

What you can expect:   He may experience swollen legs for a few weeks after the operation. If the surgeon removed veins from his leg, the blood flow returning to the heart may be slower, causing fluid to accumulate in the ankles and lower legs. The swelling can be extremely uncomfortable.

What you can do:

  • While he's resting on the bed or couch, place several pillows under his legs to raise his feet higher than his heart. Do this for an hour at a time, at least three times a day.

  • Remind him not to sit in one position for a long time or cross his legs, which can impair blood flow.

  • Once the doctor gives the OK, encourage him to walk as much as possible. Even short jaunts around the house or yard can help promote circulation.

  • Ask the doctor if elastic support stockings might be helpful. You can buy these at any medical supply store and even at some drugstores.

  • Notify the doctor if swelling worsens significantly or persists even with regular activity and elevation of the legs. Fluid buildup in the legs is a symptom of heart failure.

Other physical issues after coronary bypass surgery

A "clicking" noise or sensation in the chest

What you can expect: A patient may be able to hear or feel the two halves of his separated breastbone "clicking" or "popping." Although not uncommon in the first days after surgery, this sound or sensation should disappear once the breastbone heals.

What you can do: Check in with him to make sure the clicking is going away. Call the doctor if it's not gone within a c ouple of weeks or if it gets worse.

Discomfort and a lump at the top of the chest incision

What you can expect: As part of the healing process, a lump may develop at the top of the incision. This is a seroma, a pocket of fluid that sometimes forms after surgery or traumatic injury. Typically, the lump will disappear in about six weeks, although it may take as long as several months.

What you can do: A lump and some discomfort are normal, but notify the doctor if there's iincreased tenderness, redness, or swelling, drainage from the incision, or a persistent fever.

Emotional issues after coronary bypass surgery

Mood swings or depression

What you can expect: Depression is one of the most common emotions affecting people who've had heart surgery. One out of three patients report feeling anxious or depressed after a heart attack or heart surgery.

What you can do:

  • Distinguish between depression and "the blues." It's not surprising that someone might feel down after bypass surgery. He may be frustrated with the recovery process and unhappy that he can't do the things he once did. But if it's just a temporary case of the blues, his mood should lift as he regains strength and his pain disappears. Depression, on the other hand, is likely to linger.

  • Watch for these common warning signs of depression:

    • Frequent crying episodes

    • Feelings of hopelessness or worthlessness

    • Poor appetite or increased appetite

    • Sleeping too much or not enough

    • Increased agitation and restlessness

    • Loss of interest in life

    • Expressing thoughts of dying or suicide

  • Notify the doctor if you believe he's depressed. Depression is a serious problem that needs to be evaluated and treated.

  • Help him be as physically active as possible. Talk to the doctor and rehabilitation team about what exercises are appropriate.

  • Structure the day around activities that give him pleasure and a sense of purpose. For example, meet friends for lunch, or enjoy a leisurely walk through the mall.

Difficulty sleeping at night

What you can expect: Insomnia and fragmented sleep are common complaints after heart surgery. Normal sleep can be disrupted by pain, stress, or anxiety. He may find it difficult to fall asleep, or he may wake in the middle of the night and not be able to drift off again.

What you can do:

  • Minimize pain and discomfort at night. Arrange pillows to help him find the most comfortable sleeping position. If he has been prescribed pain medication, have him take it 30 minutes before bedtime.

  • Keep him busy so he won't nap too much during the day, but not so busy that he gets overly tired.

  • Eliminate caffeine in the late afternoon and evening.

  • Play relaxing music.

Other mental issues after coronary bypass surgery

Decreased mental function

What you can expect: It's not uncommon for people recovering from heart surgery to feel they aren't as mentally "sharp" as they were before the operation. Heart surgery puts a great deal of stress on the entire body -- including the brain.

What you can do:

  • The best way you can help is to reassure him that his cognitive skills will return with time. Just as the body needs time to recover, so does the brain. Meanwhile, you might relieve some of the pressure by taking over mentally challenging tasks like paying bills.

  • Talk to the doctor. Some medications, including beta-blockers, can decrease mental function. His doctor may be able to prescribe a different medication.

Anxiety and worry about the future

What you can expect: It's normal for a person to feel fearful after heart surgery. He may be worried that the surgery wasn't successful or that he won't recover. He may be afraid that he'll develop future complications like heart failure.

What you can do:

  • Let him talk about his fears. Don't brush off his concerns; keeping his feelings bottled up will make him feel worse. If it 's difficult for you to hear his worries, help him find a support group or online community.

  • Encourage him to keep a journal. Sometimes just writing about negative feelings can defuse them.

  • Remind him -- and yourself -- that his anxiety is most likely temporary. As recovery progresses, he's probably going to feel more like himself again.

  • Encourage him to get back into a normal routine as soon as possible. Getting dressed first thing in the morning, going for a walk outside, resuming favorite hobbies, and socializing with family and friends are all excellent ways to relieve fear and anxiety.

  • If his anxiety persists for more than four weeks, talk to his doctor. He may need counseling or antidepressant treatment.


Stephanie Trelogan

Stephanie Trelogan writes about heart disease, stroke, and depression issues that concern people caring for their aging parents. See full bio

almost 3 years, said...

My mom (75) had her surgery April 3, 2015. She is in extreme pain and is sleeping a lot. Is this normal?

over 3 years, said...

Hi, in 2012 at the age of 61yrs, I was admitted to Blackpool Victoria Hospital to undago a triple heart by pass after surgery I started terrible illusinations is the nursing staff where all against me and seeing my family in disguise and then lying on a trolley with a lot of undercover police officers watching me and two officers behind me with tronchons drone and remember saying don't it me,I also so my grave and the headstone, All this may sound ridiculous but to me it was real When I came round I had a trackiostomy and was told my lung collapsed after sugerey then I had to have a cardiac vertion has time went on and became stronger I couldn't believe how nice everybody was with me thay whare all smiling but yet I couldn't get any answers. Was I close to death? I wonder to this day! The surgeon who was a really nice man (Mr Javingoler) told me in out patients I have been very lucky he said the heart was in a bad way. Sorry for going on but nobody seems to tell me that seem to evade the issue. Kind regards

almost 4 years, said...

Thank you everyone for sharing about your experiences in relation to the content of this article about coronary bypass recovery. Please continue to work with your doctor(s) to address the physical and emotional concerns you're raising. Additionally, for those who referenced a need to speak to someone immediately about feelings of depression (in addition to speaking with licensed medical professionals offline), or a hotline such as 1-800-784-2433 may be able to assist you. Depression is serious health problem that requires attention and care from a doctor offline and cannot be resolved in comments on our articles. Please do seek help offline if you are experiencing depression and/or emotional crisis after coronary bypass. Thank you!

almost 4 years, said...

Im 42 and not ready for this life after my open heart surgery. I can relate to all the symptoms in this article. Jan 2014 i had a Open heart surgery. All my life I have been very healthy, exercised, eaten right, not smoked, tried to do the right thing. on October 2013 I had a stress attach, I had been feeling lack of energy for a long time and one day my whole body started shaking and had severe pain around my chest area. Luckily it was not a heart attach but just a warning. I went tu urgent care where they said I just had some heartburn. I insisted that I did not have that and wanted more tests. So they did, and they found out that my aorta was over 5,5cm and a valve was leaking. I had to have a surgery with in the next 3 months or I would not make it. So I decided to do it. I told my work, wish I had just started in 5 months earlier what was going on. Their response was letting me go. I did get short term disability witch I had to fight to get thru a lawyer. Surgery went well, I was out of hospital after 5 days. since then its been a struggle to get motivated to fight the daily life. I do my exercise, cardiac rehab and going to the gym 4 days a week, am after 3 months getting in really good shape. But mentally am a wreck. The only help I have gotten after surgery is from my wife, she has reschedule her job to work around my needs. My family lives in Europe, and her family has not lifted a finger to help us. Also another thing that is funny is All my friends, or at least I thought they where has vanished. I feel very lonely. Beside my wife I got no one. Every day hen she is at work Im by my self, staring at the walls, not getting anywhere, and digging my black hole deeper and deeper. I used to be very out going and social, but now I dont want to be around people at all,and I cry allot. I have nightmares every nite that my chest is splitting up and splatting blood every where. So I dont want to sleep no more. They told me I will feel better after surgery! One thing is to save my heart, BIG REWARD AND TO THE SUCCESS FOR THE SURGERY TEAM. They saved another animal. But they forgot to give me my sole back, and is doing nothing to give it back to me. I did ask for a psychologist before surgery and did not get it, I have asked for it every week since surgery, and now finally i another month I get it. I am lifted of all restrictions so I can go out finding a job now, but am not mentally ready. And right now I dont think I can wait 4 more weeks to talk to somebody. I need help or Im done, cant live like this.

almost 4 years, said...

My dad had triple bypass surgery on 03/14/14. He has had several things happen since then and we just want to make sure that these things are normal. He is having panic attacks at night when the sun starts to set (he feels as if he is going to quit breathing or suffocate) also has had several bouts of diahera, some redness at the bottom of his incision and in general fatigue and feeling as if he is an "invalid". He has fluid on his lungs but the Dr. says it is not pneumonia and is normal after being on the heart lung machine. My mother needs reassuring that she is doing everything right and it's just going to take some time.

about 4 years, said...

Hello I am 48 years old. Never smoke, Don't drink. 5'7" and 175lbs. I had zero prior warnings. On 1/9/14 had my first heart attack. Woke up chest pains but felt like gas. Took a few antiacids and about 10min pain went away. Pain was mostly under my armpits and collar bones with some tightness to the chest. Went to work next day and had similar but smaller episode. So went and got checked out. Good thing too. I was 99% blocked. I just couldn't believe it until I saw the heart cath. Wow. Only God was keeping me alive. Had my surgery on 1/13/14. Surgery day they shave you everywhere, arms, legs, chest. Give you relax meds. Wheel you down then give you the good stuff. Next thing you know you are waking up on a breathing machine. (Vent). I felt little to no pain. Once you come off vent. Here comes the hard part. Most places waste no time getting you up and moving. Sitting in chair. Doing your breathing exercises. Do Not skip these! Seems easy and trival but they work and keep your from filling up with fluid. Keeps them open. They get you up and walking asap. But assisted. Cause lots of pain meds on board. Now no one told me this eat slow! After being on vent your swallow is somehow different. And I get choked very easy. And trust me you will hate when jello or pill goes down wrong. You will hate to cough. It will hurt. still does. But do it. Its 1/28/14 and I'm home recovering. Doing my breathing exercise every hour while awake. 20 breaths. Short walks. 15min each. No less than 30min day. Key is don't lay around in bed. Sit up in chair. But don't over do it. Its still early in game for me. Still good days and bad. Drink and eat. But heart healthy. This is a wake up call and lifestyle change. Hope I said at least one helpful thing. God Bless

about 4 years, said...

Im 34 now was 33 on may 20 2012 the day of my first heart attack had 2 stents put in 3 months later in august i had a second heart attack which required a double bipass here i am 18 months later suffering from PTSD waiting for the next big one.. I have a keloid scar running down my chest and a very sensitive scar on my donor leg. my left and right breast muscles are extremely sensitive to touch, heat, and cold. I still suffer from high blood pressure usually in the 150/100 area even on the 10 mg of lisinopril to help keep it low.. at 34 i figured i could "handle" this with no problem... i couldnt have been more wrong, I am now divorced because i am scared to work because of what i feel are palpitations and pains and pressure in my left arm and chest.. I have yet to be given a treadmill stress test (lack of insurance doesnt help). Depression is a very very real issue. I have yet to find a group or anyone my age to talk about this with my therapist doesnt seem to understand and my doctors dont spend more than 5 or 10 minutes with me because of my inability to pay them. Memory issues come and all in all there are times i wish i had my DNR signed before i had the surgery 18 months later and still having severe chest pressure and anxiety im not sure how much more i can handle

over 4 years, said...

I'm a 62 year old male.On Aug. 8, 2013 I had quadruple coronary bypass surgery. Back in March 2013 I was told by my doctor that I had 4 blockages. It took over 4 1/2 months to convince my cardiologist to set me up with a surgeon. Persistance pays because on July 30, 2013 I saw a surgeon. He told me that an operation was my only chance of survival. This gave me one week to prepare. I've been all over the internet and when my day of surgery came I took it in stride. All I wanted was to get to the other side of the surgery and recover. The last thing I remember before my surgery was a nurse shaving my chest. The next thing I knew I was waking up in ICU. Very little pain which surprised me. Every chance I got in the hospital even at 3:00 AM I would walk the hospital halls. It took 6-7 weeks for my appitite and taste to return to normal. This caused me to lose 30 pounds and 4 inches off my waist. I've gained 9 pounds back but NOT the inches. Today 11 weeks after surgery all I feel is some numness in my chest's surface area and occationally I can feel the wires. Attitude is most important in your recovery proccess. If you want you life back you must take it back. No one is going to hand it back to you.

over 4 years, said...

I had a triple bypass 4.5 months ago. I wish the doctors had told me of what to expect after surgery. I have had nightmares and wondered whether I would survive thereafter. Thanks to a lot of reading up I now feel much better. I have been through shortness of breath, fever, fast heart rate, depression, pain in the chest region, chest infection, severe coughing fits, high blood pressure and presently swelling of the ankles. I went through a bronchial procedure which was unnecessary. I do believe now that exercise is the only best answer and the rest is up to God. Be happy that you are alive each morning when you wake up. Be prepared to read up as much as possible and learn to ask doctors a lot of questions. They know a lot but do not have the time, or patience to explain too much due to human preoccupations. Make notes and then ask them your questions. You will survive all the above, if you do as I mention. Keep your spirits high and remember to be grateful for the second chance God has given you. There is no need to be impatient or depressed. Get on with getting yourself well again and you may live to be a 100 year old person. I wish you all the very best and long lives.

over 4 years, said...

I am 66 years and 15 months back went under heart bypass surgery. All the 3 blocked arteries were replaced. One vein from arm and two from upper part of chest. Even today I am feeling heaviness on both sides below shoulders. Is it normal or abnormal ?

over 4 years, said...

Update sence my bypass July 6 2013. Well I had to go throw bypass again this time around in my neck. It does take very long time to heal from open heart surgery your body went throw living HELL. Well it's been over a year sense my bypass . I still feel the pains in my chest from the wires. It's been really hot here the heat been heating up the wires really feel it. Also when I got home from the hospital after surgery I felt really cold that's well last about month.

over 4 years, said...

Your comments on post surgery experiences are directly focused to the point, with no frills. It allows the patient to invoke some self actions and to progress further thoughts or issues with his doctor/surgeon as most of us have individual concerns. Thank you again for the forthright revelations.

almost 5 years, said...

Thank you for this very useful info. It was very helpful. I aam going for a Coronary Heart Bypass surgery next Tuesday, so it is very useful to prepaare myself with this valuable info. Thank you once again. KP Sinniah, Malaysia