Harvard Heart Letter

Recovering from heart surgery

Here’s what to expect once you’re home from the hospital.

Every day, thousands of people in the United States undergo open-heart surgery. This major operation leaves them with a long chest incision — and a lengthy recovery. The time it takes to fully heal will depend on the person’s age and overall health and the complexity of the operation.

The most common is coronary artery bypass grafting, which uses a blood vessel taken from another part of the body to bypass a blocked heart artery. Open-heart surgery is also done to repair or replace a faulty heart valve or to repair damaged or abnormal areas of the heart.

“For people who are in reasonable health who have open-heart surgery, we expect about 75% of their recovery to be complete in about four to six weeks,” says Dr. Prem Shekar, chief of the division of cardiac surgery at Harvard-affiliated Brigham and Women’s Hospital. During that time, pay close attention to your body, which can help you avoid setbacks and ensure a smooth recovery, he advises.

Moving while healing

You’ll feel tired and weak for the first week or so and gradually regain strength over the following month. Take it easy, but don’t just lie on the couch all day. “We encourage people to get out of the house at least twice a day. Take a short walk and try to go a little farther each day,” says Dr. Shekar. As long as you feel fine, walk as much as you like, he adds.

Most of the precautions you need to follow during the first month are to allow your breastbone to heal. For example, you should not drive, nor should you push, pull, or lift anything heavier than 10 pounds. When standing up from a chair, scoot forward so you can press down into your legs instead of using your arms to push yourself up. The same goes for getting out of bed; roll and swing your legs to the floor to avoid pressure on your upper body. A physical therapist will show you these moves in the hospital.

Traditionally, people get a small, heart-shaped pillow to bring home from the hospital. Hug it tightly to your chest if you need to cough or sneeze, which helps contain the expansion of your chest so the incision doesn’t hurt, says Dr. Shekar.

When to call your doctor

Keep a close eye on your chest incision and call your doctor if you notice any increased redness, swelling, warmth, fluid discharge, or pus. For the first two weeks, check your temperature twice a day. A slight fever is not unusual, but if your temperature is above 100.5° F on two occasions, call your doctor.

You should also weigh yourself every day. Most people come home from the hospital a few pounds heavier than normal and then gradually return to their usual weight within three weeks. But if you gain weight, you could be retaining fluid and may need a medication adjustment. Dr. Shekar also recommends using a home blood pressure monitor to check your heart rate and blood pressure every few days. Unusually high or low readings should prompt a check-in with your physician.

Managing pain

People expect heart surgery to be quite painful and are often surprised when their discomfort isn’t that bad, says Dr. Shekar. It seems counterintuitive, but the younger you are, the more pain you may feel. People in their 50s and 60s have more muscle tissue with good nerve distribution, so the chest incision tends to be more painful than for an 80-something person with lax chest muscles, he explains.

Most people are able to manage their pain with acetaminophen (Tylenol) or ibuprofen (Advil, others). Dr. Shekar prescribes a two-week course of oxycodone (OxyContin, others), which can help take the edge off sharper pain and helps people fall asleep at night. “At some time, you’ll inadvertently make an awkward move that strains the incision, and a regular pain reliever just doesn’t cut it,” he says. But most people take oxycodone for less than a week.

Finally, if you or a loved one is slated for open-heart surgery, remember to keep your eye on the prize. Dr. Shekar says his patients sometimes downplay their heart-related symptoms because they’re reluctant to undergo surgery. “But when I see them a month after their surgery, they say, ‘I didn’t realize how bad I was feeling, but now I feel so much better!’”

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