Comprehensive Physiotherapy Management in Post Coronary Artery Bypass Grafting Et Causa Coronary Artery Disease Involving 3 Vessels (CAD3VD) Case: Case Report

Nurisma Pramudiana(1*), Arif Pristianto(2)

(1) Muhammadiyah University of Surakarta
(2) Muhammadiyah University of Surakarta
(*) Corresponding Author

Abstract

Coronary heart disease is a malfunctioning of the heart caused by stenosis of the heart blood vessels which can affect one or more arteries. In these cases the patient had Triple Vessels Disease (3-VD), where there was ≥50-70% stenosis in most of the main branches of the heart blood vessels, then the patient underwent a revascularization operation Coronary Artery Bypass Grafting (CABG) with a postoperative condition, namely pain. in the sternum and lower right leg, accumulation of pulmonary sputum, decreased thoracic expansion, shortness of breath, decreased activity and functional ability. The management of physiotherapy that is given is chest physiotherapy and active and passive exercises in extremity. After 3 times of therapy, the results obtained from the degree of shortness of T0: 5 to T3: 3, the decrease in pain T0: 6 to T3: 3, then tenderness T0: 6 to T3: 3 and silent pain T0: 4 to T3: 3 increased the difference in thoracic expansion in the axilla T0: 1 cm becomes T3: 2 cm, at ICS T0: 1 cm changes to T3: 2 cm and there has been no increase in the xypoideus process, by 2 cm at T0 and T3. Activity and functional abilities were calculated using the Barthel index on T0 of the total dependency category, changing to T3: weight dependence. Chest physiotherapy and active-passive exercises in extremity can alleviate problems in post-CABG surgery.

Keywords: Coronary Artery Bypass Grafting, Chest Physiotherapy, active and pasive exercise in extremity

References

Ahmad, A. M. (2018). Essentials of Physiotherapy after Thoracic Surgery : What Physiotherapists Need to Know . A Narrative Review. The Korean Journal of Thoracic and Cardiovascular Surgery, 6516(51), 293–307. https://doi.org/10.5090/kjtcs.2018.51.5.293

Altun, D., Çınar, Ö., Özker, E., & Türköz, A. (2017). The effect of tramadol plus paracetamol on consumption of morphine after coronary artery bypass grafting. Journal of Clinical Anesthesia, 36, 189–193. https://doi.org/10.1016/j.jclinane.2016.10.030

Arroyo-Rodríguez, C., Brito-Zurita, O. R., Sandoval-Navarrete, S., Solis-Vásquez, R., Ornelas-Aguirre, J. M., Olea-Hernández, C., … Castelan-Ojeda, A. M. (2018). Risk factors for three-vessel coronary artery disease in patients of Northwest Mexico. Archivos de Cardiologia de Mexico, 88(5), 423–431. https://doi.org/10.1016/j.acmx.2018.02.009

Derakhtanjani, A. S., Jaberi, A. A., Haydari, S., & Bonabi, T. N. (2019). Comparison the effect of active cyclic breathing technique and routine chest physiotherapy on pain and respiratory parameters after coronary artery graft surgery: A randomized clinical trial. Anesthesiology and Pain Medicine, 9(5). https://doi.org/10.5812/aapm.94654

Kementrian Kesehatan Republik Indonesia. Indonesia; 2019 [update 26 september 2019 cited 07 desember 2020]. Available from: http://p2ptm.kemkes.go.id/kegiatan-p2ptm/pusat-/hari-jantung-sedunia-hjs-

Purnomowati, A., Oehadian, A., & Dewi, S. (2013). Karakteristik dan tatalaksana penderita penyakit jantung koroner dengan triple-vessel disease (3VD) di rumah sakit Dr. Hasan sadikin bandung periode tahun 2013. Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjajaran, Vol. 13.

Seo, Y. G., Jang, M. J., Park, W. H., Hong, K. P., & Sung, J. (2017). Inpatient cardiac rehabilitation programs’ exercise therapy for patients undergoing cardiac surgery: National Korean Questionnaire Survey. Journal of Exercise Rehabilitation, 13(1), 76–83. https://doi.org/10.12965/jer.1732806.403

Sultanpuram, S., Alaparthi, G. K., Krishnakumar, S. K., & Ottayil, Z. C. P. (2016). Physiotherapy Practice Patterns for Management of Patients Undergoing Thoracic Surgeries in India: A Survey. Surgery Research and Practice, 2016, 1–11. https://doi.org/10.1155/2016/9717489

Westerdahl, E. (2015). Optimal technique for deep breathing exercises after cardiac surgery. Journal of Italian Society of Anesthesiology, Analgesia, Resucitation and Intensive Care, 81(June 2014), 678–683.

DOI: 10.23917/fisiomu.v3i1.12960

Article Metrics

Abstract view(s): 791 time(s)
PDF (Bahasa Indonesia): 3232 time(s)

Refbacks

  • There are currently no refbacks.