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Heart & Cardiology/Leg and Chest Soreness/Numbness after CABG x3

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QUESTION: Dear Sir,
I am 2 years out from CABG x3 and doing ok except I still have a lot of skeletal/muscular chest soreness. Also if I sit or stand any longer than 5 minutes, sometimes less, my lower left leg and foot (the leg where a vein was taken from) will get really sore and numb, it's ok if I keep on the move or sit with my leg elevated. Is this to be expected and what would cause this?
I would appreciate your thoughts on this.
Thank-you for your time.

ANSWER: Hi James,

Sometimes there can be some nerve related damage from the saphenous vein harvest. A sensation of numbness is not uncommon, and if it has been there since the surgery that is the likely cause. If it is progressing then i would recommend having someone perform a simple neurologic assessment to ensure nothing else is going on.

Unfortunately one of the drawbacks to conventional bypass surgery is the fact that the sternotomy is a big incision that involves basically sawing through bone, cartilage, nerves and other structures in order to gain access to the heart. Despite reapproximation of the sternum with the wires it is likely that some of this disruption remains and thus the continued associated pain and unfortunately there is no great treatment for this. This is actually relatively common and some are much more sensitive to it than others. In some cases there is a sharp pain that is worsened by pressing over certain points where the wires stick out. If this pain is limiting, easily reproducible, and thought to be related to the wires then removal and replacement of the wires can be considered.

Hope that was helpful,



---------- FOLLOW-UP ----------

QUESTION: Thank-you for your expert response sir. I've recently had a ct scan which shows no lung lesions etc and my lung tests are ok also. Could my sternum discomfort possibly interfere with my ability to take a deep breath, especially when exercising. It's not so much the pain that limits my breathing, but more the feeling that my chest isn't expanding fully.
Thank-you for your time.

Answer
Hi,

I doubt very much that sternal wires alone could be involved in inability to expand the lungs fully. Its also worth noting that your pulmonary function tests would have demonstrated an abnormality if the lungs were indeed unable to reach a reasonable capacity. Rarely there can be diaphragmatic paralysis due to phrenic nerve damage post-operatively however once again this would have likely shown up on the pulmonary function tests.

Hope that was helpful,  

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Mustafa Ahmed MD

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Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease

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Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology

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http://blog.myheart.net

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Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

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MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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