Perioperative Management of Cardiac Rehabilitation in Patient Undergoing Coronary Artery Bypass Grafting: A Case Report

Abstract

Aims: To highlight the importance of early diagnosis, timely intervention, and structured cardiopulmonary rehabilitation in a high-risk patient with acute coronary syndrome (ACS) requiring coronary artery bypass grafting (CABG). Case Presentation: A 54-year-old male with poorly controlled hypertension, recent smoking cessation, and a family history of cardiovascular disease presented with exertional chest pain and dyspnea. Initially misdiagnosed as pulmonary disease, his condition progressed to acute myocardial infarction, confirmed by ECG and biomarkers. Emergency direct coronary angioplasty (DCA) was performed, followed by optimal medical therapy. Due to severe triple vessel disease, he underwent elective CABG with three grafts (LIMA–LAD, SVG–LCX, SVG–RCA). Echocardiography showed preserved LVEF (58%) and diastolic dysfunction. Postoperatively, he was enrolled in Phase I cardiac rehabilitation, including early mobilization, breathing exercises, and nursing-led mobilization, with good hemodynamic stability and functional recovery. Discussion: This case underscores the role of cardiac rehabilitation in the perioperative pathway of CABG patients. Early mobilization reduced risks of pneumonia and deep vein thrombosis, while multidisciplinary management enhanced functional recovery. Literature supports structured rehabilitation programs as safe and effective in reducing complications and improving outcomes after CABG. Conclusion: Early diagnosis, prompt intervention, and integrated perioperative care—particularly cardiac rehabilitation and early mobilization—are essential to optimize outcomes in high-risk ACS patients undergoing CABG.