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What causes sharp pain in sternum after a bypass surgery?

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Internal Medicine Specialist
Practicing since : 2000
Answered : 1417 Questions
I am a 41 year old male, 9 months post single vessel lima lad bypass surgery. I have persistent left chest wall pain. Cardio ruled out. Angio, CT etc all clear. Sternum wires have been removed too. Pain comes and goes, sometimes very sharp stabbing like pain for a few seconds. Feels musco skeletal and always in same spot to left of sternum close to ribs just below pectoral area. Sharp pain sometimes radiates into my back too. No history of anything before the surgery. Sometimes its painful on a deep breath in too. I have been given anxiety diagmosis but this is definately not anxiety pain. It certainly doesnt help the anxiety though due its location! Any ideas?
Posted Sat, 15 Feb 2014 in General Health
Answered by Dr. Sudhir 8 hours later
Brief Answer: My guess would be irritated coastal nerve. Detailed Answer: Hello, Thanks for the query. My guess would be that one of the inter-coastal nerve, which runs between ribs from back to sternum , might have got pinched or irritated, so whenever it is pinched further or gets touch by adjacent structure you get pain.I am thinking of this possibility because pain is momentary, sharp and radiating to back. Such diagnosis are difficult to confirm and even prophylactic treatment cannot be undertaken. As pain medications wont be justified for such pain. Many patients get such post operative pains whose cause cannot be determined after investigations.In most such cases, pains are neural pain.Pain is felt along the structures supplied by nerve. Hope this answers your query.Please ask if there are doubts.Regards
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Follow-up: What causes sharp pain in sternum after a bypass surgery? 4 hours later
Many thanks for your repsonse Dr XXXXXXX OK, assuming your diagnosis was correct, and pain meds are not indicated, then what (If anything, argh!!) would be the proposed treatment options for this? Would it be considered likely that this has been induced from the sternotomy surgery and is not just co-incidental. Many thanks for your time. It is highly appreciated.
Answered by Dr. Sudhir 3 hours later
Brief Answer: Yes this could be sternotomy induced. Detailed Answer: Generally such symptoms resolve or reduce with time. Mild massage, moderate exercise, weight loss if obese, use of local analgesics creams or sprays if there is frequent pain can prove helpful. In case diagnosis is confirmed the steroid injection at of pain can a option. hope this helps you. Please ask if there are doubts. Regards
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