What is coronary heart disease? Coronary arteries are the blood vessels supplying blood to the heart. If the coronary arteries become spasmodic, organically narrowed or blocked, it will cause myocardial ischemia or even necrosis, which is called “coronary heart disease” or “ischemic heart disease”. Clinically, patients can have angina pectoris, myocardial infarction, heart failure, arrhythmia and sudden death and other manifestations. So how does coronary heart disease form and develop? Atherosclerosis is the most important cause of coronary artery stenosis. Intravascular lipids, cholesterol and other substances are gradually deposited on the inner wall of the blood vessels, forming lipid plaques, gradually thickening the inner layer of the blood vessel wall, narrowing the lumen, hardening the wall, and reducing the passage of blood through the atherosclerosis, a pathological process called atherosclerosis, which usually begins in childhood and lasts for the rest of a person’s life. This pathological process is called “atherosclerosis” and usually begins in childhood and continues throughout life. This is also the reason why many patients undergo a preoperative ultrasound examination of the carotid arteries that reveals the presence of hardened plaques or even stenosis in the carotid or vertebral artery. With the gradual increase of plaque, thickening, may block the coronary arteries, so that the blood supply to the heart is gradually reduced, when the plaque blockage of the coronary artery diameter of 70% or more, the myocardium will be ischemia, hypoxia, manifested as chest pain, chest tightness, breathlessness, precordial discomfort and other symptoms, known as “angina pectoris”, usually occurs when you exert yourself, activity or emotional excitement, rest or emotional stress. It usually occurs during exertion, activity or emotional excitement, and can be relieved by resting or sublingual nitroglycerin, and in severe cases, it can also occur at rest. It should be added that many patients say that they have never had angina, but only a little chest tightness or “indescribable discomfort” in the anterior region of the heart, how can angina occur? In fact, the attack of angina is not necessarily “pain”, most people do not “pain”, but only the above mentioned “chest tightness, discomfort”, and some patients manifested as “Some patients may have stomachache, toothache, throat discomfort, etc. Some patients may not have any symptoms at all, but only have abnormal ECG or ultrasound and coronary angiography. It is only when they have an abnormal electrocardiogram or ultrasound of the heart and have a coronary angiogram that they realize that they have serious coronary heart disease. No matter how different the symptoms are, coronary angiography is the “gold standard” for the diagnosis of coronary artery disease, and if there is a problem with the results of the angiography, it is coronary artery disease. It goes on to say that plaques may rupture and form blood clots, resulting in acute occlusion of the coronary arteries, known as “acute myocardial infarction”. Patients may experience persistent chest pain or discomfort in the precordial area, radiating to the back, left forearm or throat, etc., which cannot be relieved by resting or sublingual nitroglycerin. If myocardial ischemia exceeds a certain period of time, myocardial cells will be permanently necrotic and will not be able to regenerate, and if the ischemic area is large, heart failure or sudden death may occur. Coronary arteries are divided into the left coronary artery and the right coronary artery, in which the left coronary artery is divided into the anterior descending branch and the circumflex branch after the shorter left trunk. What we usually call “three-branch disease” means that the anterior descending branch, the rotary branch and the right coronary artery are all narrowed. Why is a “left main stem lesion” considered more serious? As you can see from the figure below, the left main artery (the location indicated by the “left coronary artery” in the figure below) is located at the source of the left coronary artery, just like a blockage of the water source, all the downstream areas will be dried up, and once a severe stenosis occurs here, it will lead to ischemia of two-thirds of the heart, which is why it is said to be more serious. What is coronary artery bypass grafting? Coronary artery bypass grafting is a procedure in which the patient’s own blood vessels, such as the saphenous vein, radial artery, or internal mammary artery, are used as a “bridge” to create a new pathway for the heart’s blood supply to cross the narrowed coronary artery and anastomose with the distal blood vessel so that the blood in the aorta is enriched with oxygen and nutrients and the coronary artery becomes more oxygen-rich. The blood in the aorta, rich in oxygen and nutrients, bypasses the narrowed area and reaches the distal end, so that the ischemic myocardium at the distal end of the narrowed area is supplied with blood again, thus solving the problem of myocardial ischemia at its root. Coronary artery bypass grafting has an “immediate” effect on the relief of angina. Depending on the patient’s pre-operative condition, many patients are able to walk up and down the stairs within a few days after coronary artery bypass grafting. If they recover well, they can walk the streets a week later. One to two months after surgery, they are able to perform light work. At 3 to 4 months after surgery, recovery is almost complete. Coronary artery bypass grafting surgery is now internationally recognized as the most effective and reliable method of surgical treatment of coronary heart disease, and the success rate of the surgery can reach more than 98%. The success rate of the surgery can reach more than 98%. It can effectively relieve patients’ angina pectoris, improve patients’ mobility and quality of life, and reduce the occurrence of myocardial infarction, malignant arrhythmia and sudden death, thus prolonging the patients’ life expectancy. Will angina not recur after bypass surgery? Coronary artery bypass surgery only solves the patient’s current problem of myocardial ischemia, but does not completely cure coronary artery disease, and does not prevent the further development of coronary atherosclerosis, that is to say, after the bypass surgery, the original blood vessels that did not have stenosis, as well as the bridged blood vessels have the possibility of reoccurring stenosis or blockage, which leads to the recurrence of angina pectoris. However, the chance of this recurrence is very low. The time interval at which restenosis occurs varies from person to person. It is mainly related to whether the patient is combined with other underlying diseases and the degree of coronary artery disease itself. A very small number of patients may experience restenosis a few months after surgery, while the vast majority of patients can extend to several years or even decades. Therefore, long-term medication is still required after coronary artery bypass graft surgery. Aggressive control of the predisposing factors of coronary heart disease, such as smoking, excessive alcohol consumption, obesity, high blood lipids, diabetes mellitus, hypertension, etc., can effectively prevent the further development of coronary heart disease and avoid the recurrence of angina pectoris. It is generally believed that the 10-year patency rate of venous bridges is 60%, and the long-term patency rate of arterial bridges will be higher. However, due to the limited number of arteries in the body that can be used for bridging, and some arteries are not suitable for bridging because they are prone to spasm, have too thin a lumen, or are diseased. Even if there is a blockage of the bridge vessel, there is no need to worry too much, some patients have four bridges, three blocked after surgery, only one artery bridge is smooth, and it is not necessarily life-threatening. And with the development of medical technology, even if angina recurs, there are appropriate treatment measures to cope with, such as putting stents in the bridge blood vessels, or re-operation, etc., are possible. Will a leg bypass affect the function of the lower limbs? The saphenous vein, the longest superficial vein in the body, extends from the ankle to the base of the thigh. It is one of the most commonly used “bridge” materials for coronary artery bypass surgery because of its small curvature, sufficient length, and the caliber of the vein matches that of the coronary arteries. The human lower extremity has two sets of venous return systems, the deep vein and the superficial vein, which are rich in side branches. By removing the superficial vein, i.e. the saphenous vein, after a sufficiently long recovery period, the side branch circulation of the deep and superficial veins will be enriched and play a compensatory role, which will not have a great impact on the venous blood return to the lower limbs, and will not affect the lower limb’s motor function. Why is there swelling and numbness in the leg after vascularization? As mentioned in the previous question, due to the removal of the saphenous vein from the leg, the venous blood that used to flow through the saphenous vein needs to return through the deep veins to establish a new collateral circulation, a process that takes a period of time, usually a few months. This process takes some time, usually a few months, during which the lower limb from which the blood vessel was removed will be swollen to varying degrees. Frequent elevation of the affected limb can promote blood return and eliminate swelling. Wearing high tensile medical stockings when walking on the ground can reduce the swelling to some extent, but do not wear them for a long period of time and remove them when lying down. In addition, since obtaining the saphenous vein requires cutting the skin as well as the subcutaneous tissue, the nerves and lymphatic vessels in this area will be cut and damaged, so there will also be different degrees of numbness after the surgery, which is normal and nothing to worry about. There are two methods of saphenous vein harvesting: one is the full incision method: according to the length of the saphenous vein needed, a full incision of the skin is used to harvest the saphenous vein from the calf, which usually requires an incision of 20 to 40 centimeters long. The trauma is relatively large, swelling of the leg is more pronounced after the surgery, there is a certain chance of infection, and scarring may cause discomfort to the patient, affecting aesthetics, and postoperative swelling lasts longer. The mobility of the lower limbs remains unaffected after surgery. Due to the simple method of extraction, it is the most commonly used method in China. Another method is minimally invasive endoscopic saphenous vein extraction. It is to cut 2 to 3 small holes of 1-2 cm in length in the lower leg, and using endoscope and special instruments, separate and remove the saphenous vein completely in the subcutaneous tissue. While ensuring the quality of the vein, it greatly reduces trauma and decreases the chance of swelling, skin numbness, necrosis and infection in the patient’s lower limbs after surgery. It reduces postoperative incision pain, activity inconvenience, heals faster and is more aesthetically pleasing. This method is more widely used in Europe and the United States. What preparation is needed before bypass surgery? First of all, necessary preoperative examinations, including blood tests, electrocardiogram, chest X-ray, cardiac ultrasound, carotid ultrasound and coronary angiography, and other special tests if necessary. Secondly, you need to stop taking oral anticoagulants, such as Polivir, before the operation and wait for a certain period of time. Wait for these drugs to be metabolized and eliminated from the body so as not to increase the risk of bleeding, with the exception of emergency surgery. You also need to reduce activities, bed rest, avoid mental tension, emotional excitement, etc., do not eat too saturated forceful defecation, to keep the bowel movement, if necessary, can be drug-assisted defecation. At the same time in order to prevent postoperative respiratory complications, but also quit smoking, practice deep breathing, coughing action, avoid colds. Ensure a good night’s sleep and take sleeping pills if necessary. It is very important that you tell your supervising doctor if you have had other operations or taken other medications in the past, as well as if you have suffered from other illnesses such as glaucoma, peptic ulcers, severe hemorrhoids, cerebral embolism, etc.! How is bypass surgery performed? Coronary artery bypass grafting involves taking a section of autologous saphenous vein or other blood vessels located in the leg and bridging the gap between the aorta and the distal end of the blocked coronary artery (see the display boards in the wards), so that blood from the aorta is supplied through the grafted vessel to the distal end of the coronary artery, in order to restore the blood supply to the corresponding myocardium, to improve the ischemic state of the myocardium, and to relieve the symptoms of angina pectoris. To put it simply, a channel is created between the proximal and distal ends of the narrowed coronary arteries so that blood can bypass the narrowed area and reach the distal end. The whole procedure usually takes about 4 hours, during which the patient is under general anesthesia and in a state of sleep, and will not have any uncomfortable feeling. After the procedure, the patient will be taken to an intensive care unit for further treatment. In the care unit, medical staff will be by your side 24 hours a day to keep an eye on your condition. When will I wake up after cardiac surgery? Most of the cardiac surgeries are performed under general anesthesia. Generally, patients will gradually wake up after 6-8 hours after surgery, which is related to the patient’s age, circulatory status, duration of the surgery, metabolic status, liver and kidney function, etc. Individuals may wake up slower, so please don’t worry about it. A very small number of patients may experience brain complications and take a longer time to fully awaken. What will I feel when I wake up after surgery? When the patient wakes up after the operation, he/she will be in the care unit. The patient will have a feeling of confusion, a feeling of wanting to move, and a feeling of thirst. Due to general anesthesia, the patient has not recovered his/her respiratory function at first and needs a ventilator to help him/her breathe. There is a tube in the mouth, called “tracheal intubation”, which is very uncomfortable, but most of them can tolerate it. In addition, in the early postoperative period, the patient is unable to urinate on his or her own. A catheter is placed in the urethra to drain the urine produced. The catheter will produce a little irritation to the urethra, so that the patient feels a kind of urine holding, wanting to urinate, which is a normal phenomenon. The catheter can be removed when the patient is able to control urination on his/her own. Also, when the patient wakes up, a healthcare worker will immediately find and communicate with you, such as calling your name, opening your eyes, nodding your head, shaking hands, lifting your legs, etc. If you are able to hear well, please ask your healthcare worker to help you. If you are able to hear clearly, please try to cooperate and respond as much as possible, which will help us to make an accurate judgment of your state of consciousness. These uncomfortable feelings will disappear soon and are an integral part of the whole treatment process, so please do not worry about them. Many patients worry about the pain of the incision when they wake up from anesthesia. Please rest assured that you and your family will be treated according to the degree of pain, and if necessary, continuous pain treatment (analgesic pump) can also be carried out to alleviate the patient’s postoperative pain and discomfort. What should I pay attention to when I get out of bed for the first time after surgery? Before getting out of bed for the first time after surgery, you need to sit at the side of the hospital bed for a while to get used to it, and do not go from lying down to getting out of bed directly, so as not to cause dizziness, panic and other discomforts. The first time you get out of bed, you should not go out of the hospital room, you only need to stand on the edge of the bed or walk slowly along the edge of the bed with the help of your family, the duration should not be too long, generally 5-10 minutes. If there is any discomfort, you need to sit down in time to rest or lie down. If the patient feels well, can go to the ward corridor walking, if it is to go to the toilet, must be accompanied by family members. In addition, before the patient gets out of bed, you need to check all kinds of pipes and wires connected to the patient’s body, especially the pacemaker wires, do not pull. The pacemaker must be well protected to avoid damage by dropping and touching. In some patients, the heart rate in the early postoperative period is completely paced by the pacemaker, which will lead to serious consequences if it is damaged. Do I need to take long-term medication after bypass surgery? Coronary artery bypass grafting surgery only solves the patient’s current problem of heart ischemia and relieves angina. It does not change the causative factors of coronary heart disease, such as obesity, high blood fat, diabetes, etc. Therefore, long-term regular medication is still needed after bypass surgery. For example, lifelong aspirin; according to the lipid control situation need to take long-term lipid-lowering drugs; control blood pressure, blood glucose; nitrates need to be taken for 3 months, according to the recovery of postoperative symptoms to continue to take or stop; betalactam sometimes need to be taken for a long time; and so on. Adjustment of the dose of these drugs or stopping time need to go to the hospital for review, by the doctor for you to adjust, do not stop the drug. Some drugs have contraindications or interactions with each other, and when taking other drugs, it is also recommended that you go to the hospital, under the guidance of a doctor. Medication is the basic treatment for coronary heart disease and needs to be adhered to for a long time. What should I pay attention to my diet after bypass surgery? During the recovery period after coronary artery bypass graft surgery (usually within 1 month after the surgery), it is usually necessary to increase the intake of calories, proteins and vitamins in order to promote a speedy recovery from the surgery. However, after this period, dietary treatment, i.e., control of hyperlipidemia, is a long-term task for patients with coronary artery disease. This is because coronary artery bypass grafting surgery only treats myocardial ischemia caused by blockage of coronary arteries, rather than treating the cause of coronary artery disease. Therefore, in terms of diet, pay attention to control the occurrence of hyperlipidemia is one of the important measures to prevent and slow down the coronary arteries or re-blockage after surgery. Can I turn over after heart surgery? Many patients are afraid to turn over because of the incision in the chest after surgery, their bodies are very stiff, and their family members have no way to help them. After cardiac surgery, whether it is a center incision or a side incision, the patient can lie on his back, or lie on his left side or right side, and can change his position when resting in bed. However, it is important not to overdo it. Do not turn over frequently, get up and sit down, etc. This will increase the force on the chest incision and affect the healing of the incision. In addition, there will be 3 drainage tubes in the chest in the early stage after the operation, which are used to drain out the blood left in the chest cavity. The patient should be careful to avoid pulling on these tubes when turning over. After being discharged from the hospital and going home, the patient can turn over when resting in bed and choose a more comfortable position to help sleep. Post-operative incision problems Post-operative incision problems are very common and most easily detected, and there are many inquiries about them, so we will answer them in detail here. In cardiac surgery, the incision is usually made in the center of the chest, or on the side of the chest, or in the case of bypass surgery, in the leg to remove the saphenous vein. It is normal to experience mild redness, numbness of the skin, abnormal sensation, swelling, and even pain around the incision after the surgery, and these symptoms will generally diminish and disappear as the skin and subcutaneous tissues heal. If there is pain around the incision in the early postoperative period, painkillers can be taken to relieve the symptoms, and sleeping pills can also be taken to improve sleep, which have no effect on the healing of the incision. In patients who have a median chest incision, the sternum is sawn from the center during the surgery and is re-fixed with wires after the surgery. The sternum usually heals completely in three months or so after surgery, with older patients or those with diabetes taking longer to heal. In the early post-surgery period, if the patient does not pay enough attention to the activities, such as supporting the body with one hand, holding a child, moving furniture or lifting heavy objects, so that the fixed sternum loosening occurs, the patient in the activities of the upper limbs or coughing will feel the chest “thump thump thump”, known as the “bone friction sensation When the patient moves the upper limbs or coughs, he will feel “thumping” in front of the chest, which is called “bone friction”, and when it is serious, the steel wire can cut off the sternum, which will lead to non-healing or even infection of the incision, and require a second operation. Therefore, it is very important to actively prevent the sternum from loosening and cutting in the early post-surgical period. So how to prevent it? We introduced the correct coughing method for postoperative patients in the video of ward education. When coughing, the patient should cover both hands on the chest, clamp the chest with both upper arms, and cough while clamping the arms, which can reduce the impact of coughing action on the chest incision. In addition, the patient to lie down, sit up, there must be family members to help, if two family members, two people holding the patient’s shoulders and hands can be; if a family member, family members hold the patient’s hands, placed in front of the patient’s chest, the other hand placed on the patient’s neck under the position of the patient’s hands at the same time hold the family’s hands, symmetrical force, you can help the patient to sit up and lie down as well. If you feel the thumping sensation mentioned above, you should pay extra attention. You must strictly limit the forceful activity of the upper limbs, and at the same time make the chest strap tighter, in principle, feel the tightness when inhaling, but does not affect the breathing can be. You should also inform your supervising doctor of your sensations in a timely manner. If you find that the gauze used to bandage the chest incision has been wet with ooze, you also need to inform your doctor promptly. Usually 7-9 days after the surgery, before the patient is discharged from the hospital, the doctor will check the healing of your incision and remove the stitches. The 7-9 days after the surgery can only determine the initial healing of the incision and cannot ensure that there will be no problems in the future. After you go home, you need to keep the incision gauze for 1 day before removing it, and continue to keep the incision and the surrounding skin clean and dry, if you sweat a lot, you need to go to the hospital in time to change the gauze, and observe whether there is new redness around the incision, whether there is any water or pus, and so on, and there may also be threads coming out of the incision over a long period of time. Don’t be alarmed if any of these situations occurs, you can contact your supervising doctor or go to the hospital directly for examination. Do not treat the wound on your own to avoid increasing the risk of infection. If the wound scab has not fallen off, do not force it off, just wait for it to fall off naturally. If the incision rubs uncomfortably against the chest strap, you can wear an unbuttoned t-shirt to alleviate the direct friction between the chest strap and the incision. Neck mass above the chest incision: many patients will find that after open heart surgery, there is a piece of skin under the neck will be more prominent, with a soft feeling when pressed up, the pain is not very obvious, which is a normal phenomenon. What is not normal? If you find that this position is swollen day by day, and press on it is not soft, but there is a certain tension, like there is water inside, and even have tenderness, then you need to go to the hospital in time for examination. Shoulder and neck pain: In addition, many patients will have pain in the shoulder, back, neck and forehead after they go home from the hospital, due to the different performance of the individual’s feeling, the general pain is not serious, which is a normal phenomenon, these discomforts are mostly related to the patient’s passive position for a long time during the surgery, as well as the surgery to open up the sternum to the surrounding tissues, rib damage, the patient needs to adjust the tightness of the chest belt, the posture during sleep, and reduce the bedtime, and walk indoors appropriately. Patients need to adjust the tightness of the chest strap, sleep posture, appropriate to reduce the bedtime, appropriate indoor walking activities, adjust the mentality, etc. do not have to be overly worried. If the pain affects your sleep, you can take painkillers or sleeping pills to help you sleep. If the pain is uncomfortable for a long time or gets worse gradually, you need to go to the hospital in time. Keloid scar: Some patients have keloid scar, after the chest incision scar healing scar is very obvious, higher than the surrounding skin, forming a protrusion, protruding keloid scar and clothing friction, which will lead to pain, tingling-like sensation. In this case, try to wear cotton underwear without buttons to minimize friction. No special treatment is usually needed. Swelling in the legs: Bypass patients will have different degrees of swelling in the legs after removing blood vessels, which will take 2-3 months or even longer to recover. In the early stage of surgery, when lying in bed, patients need to raise their lower limbs 20-750px higher to promote the venous return of the lower limbs, reduce the swelling of the lower limbs and promote the healing of the incision. If the edema is not eliminated for a long time, it will lead to malnutrition of the incision, not healing, and even cause the incision to split because of excessive skin tension, leading to infection and so on. Diabetics, in particular, should be careful. Or use medical compression stockings, put them on when going down to the ground and take them off after lying down, avoid wearing them for a long time. Thread problem: Both chest incisions and leg incisions are closed with sutures. Considering the material and tension of the sutures, only the shallowest layer of intradermal tissue is sutured with absorbable sutures, and the sutures used for the tissues below the skin are non-absorbable. This part of the suture may shift to the subcutaneous as the tissue heals, especially the knot part, which may be visible on the skin. There is no need to worry about this situation, just go to our hospital or local hospital for timely treatment, and it will grow back in 1-2 days. Individuals do not pay attention, will occur around the thread infection, pus, do not squeeze yourself, you must go to the hospital for disinfection and change of medicine, to avoid aggravation or spread of infection. About chest pain need to pay attention to the problem: general pain around the incision, there is pressure localized pain, sitting position for a long time when you get up, there is chest incision out of the pulling pain, these are normal phenomena. If the postoperative chest pain is similar to the preoperative chest pain, or chest pain related to activity and exertion, need to pay attention to, it is best to go to the hospital. When can I take a shower after heart surgery? If the wound has healed, you can start to take a shower, usually after 2 weeks after surgery, when the scabs on the chest incision have faded and there is no redness, swelling or oozing from the incision. Do not soak the wound directly in the bathtub or swimming pool until your doctor gives you permission. Don’t use water that is too hot, that can make you feel dizzy, and avoid spraying the wound directly with a high velocity stream of water. Don’t rub the wound, clean it with a neutral soap with gentle movements and then gently dab the wound dry with a dry towel. This is also a better time to check for changes in the wound and contact your doctor if there is any redness, swelling or oozing. Leg wounds in bypass patients may be slower to recover, and the scabs usually do not recede until 3-4 weeks after surgery, and in some cases longer. Measures should be taken to protect the incision from soaking when showering. If the incision is still oozing, red and swollen, and the scab has not faded away, please do not shower to avoid infection, and contact your doctor or follow up promptly. How can I exercise after heart surgery? After cardiac surgery, you should be as active as you are able to be to help your early recovery. Initially, you can walk indoors and around the house, holding onto something while walking. Then, when you feel there is no difficulty, you can start walking, which is a good and effective exercise method. This method can improve blood circulation and increase muscle and bone strength, and the speed and pace of walking at the beginning should be comfortable. Later, gradually speed up the pace to increase the heart rate and breathing rate. You can walk three times a day, five minutes each time, start from a comfortable walk, and then gradually increase the time and distance of the walk, in order to be able to tolerate, a few more walks a day, more beneficial than a long-distance walk a little, adhere to the daily walks, and gradually increase the distance of the daily walks as long as it can be tolerated, you can slowly go up the stairs, up a small hill, in the process of exercise and exercise, if chest pain occurs It should be stopped immediately. Shortness of breath, asthma and fatigue should also be stopped immediately. If these symptoms disappear, the activity can be continued at a slower pace and then increased day by day. Fatigue is unavoidable until you have regained your full strength. You may feel your heart beating very strongly during activity, but as long as the heartbeat does not beat unusually fast, this is normal and should not be a cause for concern. In rare cases, some people feel a sudden loss of control of the heart or a rapid heartbeat, and may feel mild dizziness, fatigue, and an irregular pulse; if any of these conditions are present, please contact your physician. Here are the training recommendations. Week 1: Take a five-minute walk twice a day. Week 2: Take a ten-minute walk twice a day. Week 3: Take a twenty-minute walk twice a day. Week 4: You should increase your walks to one kilometer per day. In winter or hot summer, you may not be able to walk outdoors. If this is the case, you can rent or buy an indoor bicycle or exercise machine and exercise for 30 minutes twice a day. Instead of exercising outdoors, you can walk slowly on your jogging machine (gym). Can I drink alcohol after heart surgery? Whether drinking alcohol has a good or bad effect on a cardiac patient cannot be determined in absolute terms. Moderate consumption of alcohol is feasible, but patients with diabetes, high triglycerides or poor cardiac function should avoid alcohol altogether, as alcohol consumption will aggravate pre-existing conditions. Patients taking warfarin for valve surgery should not consume large amounts of alcohol, as large amounts of alcohol will increase the burden on the heart, and at the same time will affect liver function, which will have an effect on the metabolism of warfarin, thus affecting the anticoagulation effect. In the absence of these problems, you can still enjoy a small glass of wine before a meal or at bedtime, but you would be better off limiting your drinking to one glass of wine or one glass of beer twice a day. In addition, alcohol still has harmful effects on the major organs of the body, and because it increases the side effects of sleeping pills, do not mix sleeping pills, tranquilizers and alcohol if you are on medication. Post-operative sexual life The knowledge about sex has changed in recent years, and it is now believed that the energy required for sex is no more loaded for heart disease than for other physical activities. If you can walk at a medium speed and climb stairs easily, or climb 2-3 flights of stairs without any discomfort, you can resume your sexual life, but you have to keep in mind that the healing of the sternum takes about three months. Protect them from pressure on the sternum. You should watch out for pain and shortness of breath, fatigue, or abnormal heartbeat, such as significant changes in heart rate and rhythm. If these symptoms occur, you should stop your activity immediately and go to the hospital. You should know clearly that coronary atherosclerotic heart disease does not have the slightest effect on your sexual organs and sexual function, therefore, heart disease will not lead to reduced sexual function in men or women, however, patients with this heart disease, accompanied by other types of vascular disease or taking certain medications which can interfere with normal erection or cause impotence, and you suffer from heart disease which leads to psychological stress, can also cause you to suffer in the sexual function of the You have a heart condition that can cause psychological stress, which can also cause you to malfunction sexually. Neither you nor your partner should feel pressurized by the process. You should allow yourself enough time to make a step-by-step adjustment, and generally speaking, a return to normal life requires both good mental and physical conditioning. When should I start working after surgery? Your return to work will depend on your energy and stamina after surgery. Avoid making major decisions such as investments, finances, work, family, etc. for at least one month after surgery. In the process of surgical hospitalization, has consumed a lot of energy, after surgery, feel exhausted, this is normal, everyone will be like this, as long as there is patience, your mental state and physical ability will gradually recover, in your discharge 4-6 weeks later, you can and your doctor, to discuss the issue of returning to work, due to the fact that each person’s situation is different, the physical ability of the different, as well as engaged in the duration of the work, the degree of tension, All these factors must be taken into consideration. Early participation in physical labor may affect your long-term prognosis. Please take this into account when preparing for work or consult your doctor.