Podcast
Questions and Answers
What does CABG stand for?
What does CABG stand for?
Chest strain should be avoided during recovery from CABG surgery.
Chest strain should be avoided during recovery from CABG surgery.
True
What should be monitored regularly post-CABG surgery?
What should be monitored regularly post-CABG surgery?
Heart rate, rhythm, blood pressure, and ECG
Aerobic Exercise after CABG should start with _______ activities.
Aerobic Exercise after CABG should start with _______ activities.
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What is considered a temporary contraindication to exercise post-CABG surgery?
What is considered a temporary contraindication to exercise post-CABG surgery?
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What is the recommended RPE during the main exercise session post-CABG?
What is the recommended RPE during the main exercise session post-CABG?
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What should the target heart rate be during aerobic exercise after CABG?
What should the target heart rate be during aerobic exercise after CABG?
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Permanent contraindications to exercise after CABG surgery generally exist.
Permanent contraindications to exercise after CABG surgery generally exist.
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The principle of keeping movements controlled and arms close to the body post-CABG is known as _______.
The principle of keeping movements controlled and arms close to the body post-CABG is known as _______.
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What is one of the main exercises recommended during cardiac rehabilitation?
What is one of the main exercises recommended during cardiac rehabilitation?
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Study Notes
Cardiac Rehabilitation for CABG Patients
- 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).
Exercise Reintroduction
- 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.
Subjective and Objective Assessments
- Relevant subjective questions should be asked to gauge patient condition.
- Objective tests include:
- Manual HR and rhythm check
- Resting BP measurement
- Blood oxygen saturation (SPO2)
- Sternal stability assessment
- ECG (if available)
- Exercise capacity (6-Minute Walk Test - 6MWT)
- Neuromuscular strength tests (30 seconds sit-to-stand or 5x STS)
- Questions on depression and quality of life (QOL)
Risk Stratification
- Patients categorized as moderate to high risk require monitoring for:
- Residual coronary artery disease
- Post-surgical arrhythmias
- Surgical complications (wound infections, sternal instability)
Exercise Contraindications
- 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.
Clinical Considerations for Exercise Prescription
-
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.
Aerobic Exercise Details
-
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.
Patient Instructions for First Session
-
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.
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Description
Test your knowledge on post-CABG surgery recovery guidelines. This quiz covers important aspects such as exercise recommendations, monitoring, and contraindications after Coronary Artery Bypass Grafting. Ensure you understand the key points for a safe recovery.
