Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to go around a blockage to reach your heart. The surgery is used to treat coronary heart disease. This article discusses what you need to do to care for yourself when you leave the hospital.
- The apical pulse is the pulse over the top of the heart, as typically heard through a stethoscope with the patient lying on his or her left side. The heartbeat consists of two distinct sounds.
- A new system uses a smartphone or computer camera to take video of your face to check your pulse and breathing rate. It could help with telemedicine. Smart speaker checks for irregular heartbeat.
Arrhythmia, also known as cardiac arrhythmia or heart arrhythmia, is a group of conditions in which the heartbeat is irregular, too fast, or too slow. The heart rate that is too fast – above 100 beats per minute in adults – is called tachycardia, and a heart rate that is too slow – below 60 beats per minute – is called bradycardia. The statistical department carries regular surveys on the “manpower needs and wages” situation in various sectors. In all, over a dozen different activities are examined; all but one (manufacturing) are services. They run the gamut from the obvious ones, gambling or banking, to some less visible. Body position: Resting, sitting or standing, your pulse is usually the same. Sometimes as you stand for the first 15 to 20 seconds, your pulse may go up a little bit, but after a couple of minutes it should settle down. Emotions: If you’re stressed, anxious or “extraordinarily happy or sad” your emotions can raise your pulse.
Your surgeon took a vein or artery from another part of your body to create a detour, or bypass, around an artery that was blocked and could not bring enough blood to your heart.
Your surgery was done through an incision (cut) in your chest. If the surgeon went through your breastbone, the surgeon repaired it with wire and a metal plate, and your skin was closed with stitches. You also had an incision made in your leg or arm, where the vein was taken to be used for the bypass.
After surgery, it takes 4 to 6 weeks to completely heal and start feeling better. It is normal to:
- Have pain in your chest area around your incision
- Have a poor appetite for 2 to 4 weeks
- Have mood swings and feel depressed
- Have swelling in the leg that the vein graft was taken from
- Feel itchy, numb, or tingly around the incisions on your chest and leg for 6 months or more
- Have trouble sleeping at night
- Be constipated from pain medicines
- Have trouble with short-term memory or feel confused ('fuzzy-headed')
- Be tired or not have much energy
- Have some shortness of breath. This may be worse if you also have lung problems. Some people may use oxygen when they go home.
- Have weakness in your arms for the first month
You should have someone stay with you in your home for at least the first 1 to 2 weeks after surgery.
Learn how to check your pulse, and check it every day.
Do the breathing exercises you learned in the hospital for 4 to 6 weeks.
Shower every day, washing the incision gently with soap and water. DO NOT swim, soak in a hot tub, or take baths until your incision is completely healed. Follow a heart-healthy diet.
If you feel depressed, talk with your family and friends. Ask your health care provider about getting help from a counselor.
Continue to take all your medicines for your heart, diabetes, high blood pressure, or any other conditions you have.
- Do not stop taking any medicine without first talking with your provider.
- Your provider may recommend antiplatelet (blood-thinning) drugs such as aspirin, clopidogrel (Plavix), prasugrel (Effient), or ticagrelor (Brilinta) to help keep your artery graft open.
- If you are taking a blood thinner, such as warfarin (Coumadin), you may need to have extra blood tests to make sure your dose is correct.
Know how to respond to angina symptoms.
Stay active during your recovery, but start slowly.
- Do not stand or sit in the same spot for too long. Move around a little bit.
- Walking is a good exercise for the lungs and heart after surgery. Do not be concerned about how fast you are walking. Take it slow.
- Climbing stairs is OK, but be careful. Balance may be a problem. Rest halfway up the stairs if you need to.
- Light household chores, such as setting the table, folding clothes, walking, and climbing stairs, should be OK.
- Slowly increase the amount and intensity of your activities over the first 3 months.
- Do not exercise outside when it is too cold or too hot.
- Stop if you feel short of breath, dizzy, or any pain in your chest. Do not do any activity or exercise that causes pulling or pain across your chest, such as using a rowing machine or weight lifting.
- Keep your incision areas protected from the sun to avoid sunburn.
Do not drive for at least 4 to 6 weeks after your surgery. The twisting involved in turning the steering wheel may pull on your incision. Ask your provider when you may return to work, and expect to be away from work for about 6 to 8 weeks.
Do not travel for at least 2 to 4 weeks. Ask your provider when travel is OK. Also, ask your provider before starting sexual activity again. Most of the time it is OK after 4 weeks.
You may be referred to a formal cardiac rehabilitation program. You will get information and counseling regarding activity, diet, and supervised exercise.
For the first 6 weeks after your surgery, you must be careful about using your arms and upper body when you move.
- Do not reach backward.
- Do not let anyone pull on your arms for any reason -- for instance, if they are helping you move around or get out of bed.
- Do not lift anything heavier than 5 to 7 pounds (2 to 3 kilograms).
- Do not do even light housework for at least 2 to 3 weeks.
- Check with your provider before using your arms and shoulder more.
Brushing your teeth is OK, but do not do other activities that keep your arms above your shoulders for any period of time. Keep your arms close to your sides when you are using them to get out of bed or a chair. You may bend forward to tie your shoes. Always stop if you feel pulling on your breastbone.
Your provider will tell you how to take care of your chest wound. You will likely be asked to clean your surgical cut every day with soap and water, and gently dry it. Do not use any creams, lotions, powders, or oils unless your provider tells you it is OK.
If you had a cut or incision on your leg:
- Keep your legs raised when sitting.
- Wear elastic TED hose for 2 to 3 weeks until the swelling goes away and you are more active.
Call your provider if:
- You have chest pain or shortness of breath that does not go away when you rest.
- Your pulse feels irregular -- it is very slow (fewer than 60 beats a minute) or very fast (over 100 to 120 beats a minute).
- You have dizziness, fainting, or you are very tired.
- You have a severe headache that does not go away.
- You have a cough that does not go away
- You are coughing up blood or yellow or green mucus.
- You have problems taking any of your heart medicines.
- Your weight goes up by more than 2 pounds (1 kilogram) in a day for 2 days in a row.
- Your wound changes. It is red or swollen, it has opened, or there is more drainage coming from it.
- You have chills or a fever over 101°F (38.3°C).
Off-pump coronary artery bypass - discharge; OPCAB - discharge; Beating heart surgery - discharge; Bypass surgery - heart - discharge; CABG - discharge; Coronary artery bypass graft - discharge; Coronary artery bypass surgery - discharge; Coronary bypass surgery - discharge; CAD - bypass discharge; Coronary artery disease - bypass discharge
Fihn SD, Blankenship JC, Alexander KP, et al. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2014;130(19):1749-1767. PMID: 25070666 pubmed.ncbi.nlm.nih.gov/25070666/.
Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012;126(25):3097-3137. PMID: 23166210 pubmed.ncbi.nlm.nih.gov/23166210/.
Fleg JL, Forman DE, Berra K, et al. Secondary prevention of atherosclerotic cardiovascular disease in older adults: a scientific statement from the American Heart Association. Circulation. 2013;128(22):2422-2446. PMID: 24166575 pubmed.ncbi.nlm.nih.gov/24166575/.
Kulik A, Ruel M, Jneid H, et al. Secondary prevention after coronary artery bypass graft surgery: a scientific statement from the American Heart Association. Circulation. 2015;131(10):927-964. PMID: 25679302 pubmed.ncbi.nlm.nih.gov/25679302/.
Morrow DA, de Lemos JA. Stable ischemic heart disease. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 61.
Omer S, Cornwell LD, Bakaeen FG. Acquired heart disease: coronary insufficiency. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 59.
Updated by: Micaela Iantorno, MD MSc FAHA RPVI, Interventional Cardiologist at Mary Washington Hospital Center, Fredericksburg, VA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Relationship
Each heartbeat creates an arterial blood flow pulse that can be felt on the skin over the artery. Normal, healthy, average heart rates vary by an individual's age, body mass, and fitness level. Other physiological, but not health related, influencers of heart rate (pulse) include air temperature and changing body positions. In hot and humid conditions, the heart may beat faster in response to the physical stressors the heat causes; cold may have the same effect. Alternately, if a person sits or lies down for a period of time, resting heart rate may decrease. When that person stands up, or gets up quickly, the heart rate may jump up as well in order to supply the now-active body's needs.
Average Heart Rate and Pulse
Normal, healthy adults who are reasonably fit and not overweight, and do not smoke or drink heavily, will have resting heart rates between 60 and 100 beats per minute (bpm); their pulse will reflect this. Average, healthy teenager heart rates are the same as those for adults, while children under 10 years of age experience higher heart rates and pulses:
- Newborns (1-30 days old) = 70-190
- Infants (1-11 months = 80-160
- Toddlers (1-2 years old) = 80-130
- Preschoolers (3-4 years old) = 80-120
- Elementary Age (5-10 years) = 70-115
Athletes share the same range with others in their age group, but teen and adults who are excessively active and fit may have resting heart rates and pulses as low as 40 bpm.
Variability
If a person's pulse, equivalent to heart rate, is frequently or regularly above or below average for their health and fitness level, there are a variety of reasons this may be the case. Some variations are attributed to positive factors, such as an increase in healthy activity and good stress management. Others variations have negative root causes, like adverse reactions to medications, smoking, and being overweight, and can indicate a potential problem for heart health.
One National Institute of Health (NIH) study that evaluated data from the records of approximately 64,000 children who experienced conditions worthy of an emergency room visit indicated that body temperature had a distinct effect on their heart rates. The UK study showed that a one-degree change in body temperature could increase or lower the pulse by as much as 10 beats per minute.
According to the Copenhagen Heart Study, a person is twice as likely to die from heart problems if their RHR is 80, compared with someone whose RHR is below 50. And three times as likely to die if their RHR is over 90.
Resolving unhealthy variables may be as straightforward as combining yoga body movement with meditation to increase core strength and decrease stress[1], or as simple as layering for changeable weather to reduce body temperature fluctuations. Limiting exposure to non-prescribed chemical influences and maintaining a healthy body weight are also heart healthy.
During Exercise
Beyond exercising for health and fitness, there are a number of activities that cause exertion, everything from sexual relations to standing up quickly from a prone position. For most people, heart rate and pulse will not go above 220 beats/minute during these times, nor should that high of a heart rate be accepted for more than minutes based on activity level and duration as a variety of studies reported by Cleveland Clinic indicate that repetitive, excessive heart rate experienced, for example, by repeat marathon runners, may cause heart muscle damage leading to arrhythmia (irregular heart palpitations) and an assortment of heart conditions.
Exercise Target Zone
For active individuals who want to keep their heart rate in a healthy and sustainable condition while exercising, sports medicine practitioners and the American Heart Association recommend setting a target heart rate, which can be measured by periodic pulse taking. Evernote drawing. The formula for a person's target heart rate during exercise or sustained exertion is to subtract the individual's age from a heart rate of 220, then keep the pulse within 50 to 100% of that range based on fitness. So, a 50-year-old person who is reasonably fit should consider a target heart rate no higher than 145 bpm.
Body Size, Mass, and Fitness
A person who is very petite and has an average fitness regimen, or who is physically large but not overweight or unhealthy, may have pulses, or heart rates, which fall outside of the normal range. This is not indicative of a health problem; it is just a factor of body mass and, perhaps, corresponding heart size and vascular capacity.
However, excessive weight can cause the heart to beat faster at all times, and this condition may lead to tachycardia, a condition characterized by a heart rate that is frequently or regularly 100+ beats per minute. Heart and vascular damage, and even failure can result. Fitness, on the other hand, especially if extreme, may result in a person's resting heart rate being as low as 40 bpm, which is not likely to be an indication of bradycardia, or a regular resting heart rate below 60 bpm in someone who is not athletic.
Health Conditions and Obesity
Health problems, disease, heart conditions, and other afflictions may be indicated by abnormal heart rates or pulses. Anyone who is concerned about his or her pulse and related heart rate should consult a doctor. Addressing the health hot topic of childhood obesity, one study, which looked at medical tests of about 40,000 teens, concluded that obesity increases both hypertension (high blood pressure) and resting heart rate.
Smoking, Medications, Alcoholic Beverages
Prescription medicines, illegal drugs, alcoholic beverages, smoking, and caffeine can affect one's heart rate, sometimes dangerously so. For example, one study published by the National Institute of Health (NIH) compared heart rates in about 300 20-somethings. Resting heart rates for the smoking population were significantly higher than for the non-smokers, and the smokers failed to achieve the desired peak heart rate in a treadmill test, indicating diminished heart rate capacity.
Sleep
Data from Fitbit also shows a correlation between sleep and resting heart rate.[2] The data indicated that average resting heart rate was lowest for people who slept around 7 hours per night. Resting heart rate tended to rise for people who slept less or more than that, with the increase being more pronounced for people who slept 9 hours a day vs. those who slept 5 hours a day.
Monitoring
Irregular Pulse Interval
Anyone who is making a change from a sedentary lifestyle to an athletic lifestyle, for example, or who has heart and general health concerns, may benefit from monitoring pulse and corresponding heart rate. For most people, it is easiest to find the pulse in the wrist or on the neck, just below the jaw (carotid artery); pulse can also be felt, though typically not as strongly, on the temple, groin, back of knees, stomach, and even on the inside and top of foot.
![Irregular Pulse Irregular Pulse](/uploads/1/3/7/6/137631816/851737221.jpg)
To measure pulse and heart rate, place two fingers on the wrist or other pulse location and press gently until a measurable beat is detected. Using a watch or clock, count the heart beats for 30 seconds, then double that number to get the pulse and heart rate per minute. These measurements can be logged at regular intervals with notations about corresponding activity for delivery to a medical practitioner if out-of-norms exist and are a concern.
Alternatively, there are many heart rate (pulse) monitors on the retail market designed primarily for tracking pulse during exercise. Athletes find them useful for evaluating and adjusting fitness and exertion levels. Using trackers, like those made by Fitbit and Jawbone, may also help individuals with abnormal heart rate conditions to determine what causes them. Commercially available products include wristbands, chest straps, and armbands, with most delivering digital readouts.
What Causes Irregular Pulse Rate
Watch the video below to learn how to check a heart rate by taking a pulse.