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Effort dyspnea after coronary bypass surgery.
K Huttunen1, S Ekeström, R Jonasson
1Department of Thoracic Surgery, Karolinska Hospital, Stockholm, Sweden.
Scandinavian Journal of Thoracic and Cardiovascular Surgery
|January 1, 1988
Summary
Following coronary artery bypass surgery (CABS), some patients experience persistent effort angina or new-onset dyspnea. Long-term CABS evaluation must consider both symptoms for comprehensive patient assessment.
Area of Science:
- Cardiology
- Thoracic Surgery
- Pulmonary Medicine
Background:
- Coronary artery bypass surgery (CABS) is a common intervention for angina pectoris.
- Long-term outcomes of CABS require continued investigation beyond initial recovery.
- Understanding persistent symptoms post-CABS is crucial for patient management.
Purpose of the Study:
- To evaluate the long-term incidence of effort angina and effort dyspnea after coronary artery bypass surgery (CABS).
- To investigate the characteristics and potential causes of dyspnea in angina-free patients post-CABS.
Main Methods:
- Prospective follow-up of 100 consecutive patients for 6-36 months after CABS.
- Assessment of symptoms including angina and dyspnea.
- Exercise testing, chest radiography, spirometry, pulmonary scintigraphy, and cardiac catheterization in select patients.
Main Results:
- Of 98 survivors, 35 reported effort angina.
- Nine (14%) of 63 angina-free patients reported dyspnea limiting activities.
- These nine patients denied chest pain during exercise tests; dyspnea was the limiting symptom.
- Pulmonary scintigraphy ruled out pulmonary emboli.
- Cardiac catheterization in three patients revealed left myocardial hypokinesis and elevated pulmonary capillary wedge pressure during exercise.
Conclusions:
- Effort angina remains a significant issue for some patients after CABS.
- Dyspnea can be a limiting symptom in angina-free patients post-CABS, potentially indicating underlying left myocardial failure.
- Long-term follow-up protocols for CABS should incorporate assessment for both effort angina and effort dyspnea.