CABG Surgery Recovery Quiz

Study Notes

Coronary artery bypass surgery (CABG) restores blood flow by bypassing blocked coronary arteries.
Recovery requires avoiding chest strain and performing regular checks of heart rate (HR), rhythm, and blood pressure (BP).

Gradual reintroduction of aerobic and resistance exercises is essential to enhance cardiovascular endurance and strength.
KMIT (Keep Your Move in the Tube) principles recommend limited upper body motion during initial recovery.

Patients categorized as moderate to high risk require monitoring for:
- Residual coronary artery disease
- Post-surgical arrhythmias
- Surgical complications (wound infections, sternal instability)

Temporary contraindications to exercise include:
- Unstable vital signs (e.g., uncontrolled hypertension, arrhythmias, angina)
- Sternal instability (consider KMIT)
- Severe shortness of breath or signs of heart failure (monitor for fluid retention or weight changes)
Permanent contraindications are rare unless long-term complications arise.

Aerobic Exercise:
- Start with low-intensity activities (walking/cycling) for 10-20 minutes per session, 3-5 days/week.
- Target heart rate should be below 20 bpm over resting rate, with RPE of 9-11.
- Gradually increase duration and intensity based on tolerance.
Resistance Training:
- Avoid for the first 6-8 weeks due to healing.
- Post-clearance, introduce light resistance exercises (1-2 sets of 10-15 reps) focusing on lower body movements.
Sternal Precautions (KMIT):
- Limit movements to avoid excessive strain, keeping arms close to the body and avoiding lifting over 5-10 lbs early in recovery.
Monitoring During Exercise:
- Regular checks of heart rate, rhythm, BP, and ECG are crucial to identify issues such as arrhythmias or ischemia.
Progression Plan:
- Aim for moderate-intensity aerobic exercise (40-60% of heart rate reserve) for 30-60 minutes, 4-5 days per week after 8 weeks, alongside light resistance exercises.

Walking Exercise Plan:
- Frequency: 3-5 days/week
- Intensity: RPE 9-11
- Duration: Start with 10 minutes, progressing to 20-30 minutes.
- Mode: Walking on flat surfaces, treadmill, or outdoors.
- Clinical reasoning: Low impact, accessible form of exercise promoting cardiovascular fitness while minimizing strain.

Warm-up (5 minutes):
- Begin with a slow walk, arms relaxed, focus on deep, steady breaths to elevate heart rate gently.
- Aim for an RPE of 6-8 (very light).
Main Exercise (Walking):
- Walk at a comfortable pace targeting RPE of 9-11 (light exertion).
- Maintain a steady breathing pattern; conversation should be possible.
- Duration: Start at 10-15 minutes with a goal of increasing to 30 minutes over time.