Pain after open heart surgery

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Submitted by Dr T on December 2, 2013 – 3:29pm

Question: 
Dear Dr T,Following a CABG X3 in Sept 2012 I have had ongoing chest soreness. I had an echo done in the summer which showed slight heart damage and an EF of 50-55%. At my own request I also had a treadmill stress test about 2 months ago and I lasted 18 minutes with chest soreness which didn’t get any worse during the test and thankfully the ‘result was negative with an excellent level of exercise.’ On the bike today during a hill climb I suddenly had fairly bad pain across my chest accompanied by ‘skipped beats’ every two or three beats (I had the skips before surgery and they have never given me any trouble when exercising) my heart rate did return to the 80’s though in about 1-2 minutes and I felt ok otherwise. When I stopped the pain subsided and I was able to carry on with no real problems although my chest still felt/feels sore. I guess my question is as follows: is a treadmill test a good indicator of everything being ok and could the pain today have merely been chest wall pain? I’m 47.Thank-you
Hi James,
I cannot tell whether this latest episode is different from the your previous pains that appear more muscular skeletal in nature, but because this episode appears different recommend another cardiac stress test or a CTCA to rule out a sudden graft failure.  Persistent muscular skeletal pains sometimes are the result of painful sternal wires, that  (if so) can be easlily removed with a minor operation.
Hope this helps,

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