Cardiac Surgery Patients: Think Posture!

If you just had your chest recently surgically opened, the last thing you want to think about is stretching, but after time it becomes very important. You may not physically remember the pain of surgery but your body does. It gradually rounds the shoulders forward, the head is carried slightly more forward, and these changes make the subtle curve in the low back gradually flatten. Many patients when they first attend cardiac rehabilitation complain of pain and spasm to their upper back and shoulders. When I worked in physical therapy I would have many patients present several years after open heart surgery with low back pain. Many had the characteristic posture I described above.

Here are a few suggestion to help you in the healing process.

Be very aware of your posture – if you are sore, think about what posture you are in. Are you seated with your shoulders slumped and head forward? If so adding a lumbar support to your chair will help to straighten your back posture. Another suggestion is to get up and move more frequently.

Pain in the shoulder blade region?

If so begin with gentle chest stretching and shoulder stretching. It is very important you avoid pain. I usually wait until my patients are approximately 6 weeks in recovery before initiating this. Do not take any stretch to pain. Do not bounce stretches.

There are three different postures to get the different muscle groups of the chest. One leg is forward simply to maintain the curve of the low back. Hold the stretch 10 to 15 seconds, repeat 1-2 times. It is ok to do this stretch a few times per day.

   These are other good stretches for the chest

Upper back stretching

The muscles act very similar to pulleys. If one side shortens the other side lengthens. If the muscles of the chest are short the muscles of the upper back are stretched. Prolonged stretch leads to muscle spasm, and this makes many people feel like they have knots in their upper back. There is a great stretch for this.

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Reach down grasp opposite knee with hand (left hand grasp right knee). Relax your head pull up gently, hold 10-15 seconds. Repeat with opposite hand/knee. repeat one to two times.

Use a lumbar support in your favorite chair, while driving, or sitting for a prolonged time. You can either purchase one at your local medical supply/pharmacy, or you can simply roll up a small towel and put it in the small of your low back.

 

 

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Heart disease medical terms to know

OK so you have recently been released from the hospital and there are a lot of new words you have heard thrown around. Lets talk about what these mean.

Myocardial infarction means heart attack.

heart attack occurs when blood flow to a part of your heart is blocked for a long enough time that part of the heart muscle is damaged or dies.

STEMI heart attack is a serious form of heart attack.

STEMI is the abbreviation for an “ST-elevation myocardial infarction.” A STEMI heart attack is identified by a test called an electrocardiogram (EKG or ECG) that records the electrical activity of your heart. If this test shows something called “ST-elevation,” you are having a STEMI heart attack. This type of heart attack is typically caused by complete obstruction of a coronary artery – an artery that delivers blood to the heart. A STEMI needs to be recognized quickly and is best treated by emergency angioplasty and stenting.

Non-STEMI  is a medical term for “non-ST-elevation myocardial infarction.”

While they may not be as serious as the STEMI heart attack, they are still heart attacks and result in heart muscle death. A non-STEMI heart attack does not show an elevated ST segment on an electrocardiogram.  A NSTEMI should also be recognized quickly and is best treated by medications and early angioplasty and stenting. The NSTEMI is usually diagnosed through blood work which is repeated several times. A patient who had suffered from a myocardial infarction would have an area of damaged heart muscle and so would have elevated cardiac troponin levels in the blood.

Ejection fraction is a measurement of the percentage of blood leaving your heart each time it contracts.

When the heart beats, the heart contracts and relaxes. When your heart contracts, it t of the pumping chamber (ventricles). When your heart relaxes, the chambers or ventricles refill with blood. No matter how forceful the contraction, it doesn’t empty all of the blood out of a ventricle. The term “ejection fraction” refers to the percentage of blood that’s pumped out of a filled ventricle with each heartbeat.

A normal LV ejection fraction is 55 to 70 percent. The ejection fraction may decrease if:

  • A heart attack has damaged the heart muscle such that it cannot forcefully contract
  • The valves of the heart are not working properly
  • Blood pressure has been uncontrolled  for a long period of time
  •  weakness of the heart muscle, such as dilated cardiomyopathy