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What Causes Cough Post Coronary Artery Bypass Graft Surgery?

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Posted on Mon, 7 Sep 2015
Question: I have undergone a CABG with two grafts and suggested medication: Dilzem 30 thrice daily, Simvastatin 10mg and Clopilet. One month after CABG, I experienced a cough which is continuing (for 1-month now). I had a lungs problem and used to take Budamate inhalation for the past 10 years. I contacted my pulmonologist due to this coughing and he suggested to increase the inhalation dose along with tablet AB Phylline SR200 daily for 1-month, after a PFT & Chest X-ray. But even after 10 days of taking these, there is no indication of deterioration in coughing. I doubt whether this coughing is due to my breathing problem or due to the new medication started after CABG. Please advise. Thanks, XXXXX XXXXXXX Mob: 0000.
doctor
Answered by Dr. Prasanna Heijebu (1 hour later)
Brief Answer:
Need to rule out cardiac cause.

Detailed Answer:
Hi Sir,

I understand your query and concern.

Cough after CABG shouldn't be neglected as it may be due to Residual volume overload Post Bypass grafting or pulmonary infection.

So I advise you to get a chest X ray complete blood picture ,PFT at the earliest.(if already done,upload me the reports).

Once confirmed a short course of diuretics and cough suppressant s will relieve your symptoms.

Continue with your present medication.

I also advise you to do breathing exercises and chest physiotherapy by consulting your doctor.

Post your further queries if any,

Thank you.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Prasanna Heijebu (13 hours later)
Uploaded the following as suggested by you:
i) PFT Report
ii) Chest X-ray copy
iii) CABG Discharge Summary (6-pages)

Please have your valuable comments & advice.

Thanks
XXXXX
doctor
Answered by Dr. Prasanna Heijebu (22 hours later)
Brief Answer:
Cough is due to pre-existing lung problem only.

Detailed Answer:
Hello, Sir.

I understand your concern.

I have carefully gone through all your uploaded reports.

The operative procedure is well executed. post-operative parameters are within normal limits.The cardiac function as evidenced by echo(pre-op and post-op) showed good cardiac function(LV function)

Hence, a cardiac cause which was initially though can be ruled out.

A cough in your case is due to exacerbation of pre-existing COPD disorder(breathing problem).New drugs prescribed (post-surgery )are not involved in causing the cough.

This is evident both on X-ray(showing bilateral hyper lucent lung fields) and on PFT- showing mixed pattern airway obstruction.Even pre-operative HRCT chest revealed basal lung collapse.

Hence, I advise you to continue with the Pulmonologist's prescribed medications for 1 month along with cardiac medications.

After one-month repeat PFT's and X-ray chest.

Post your further queries if any.

Thank you.








Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Prasanna Heijebu (50 minutes later)
Thank you doctor for your valuable advice.

The cough is continuing for the last one month; the medication for lung problem started only 10-days before. Is it required to consult the Pulmonologist again immediately (before 1 month suggested), as the cough is continuing without any suppression?

Please give your suggestion.

Thanks
XXXXX
doctor
Answered by Dr. Prasanna Heijebu (19 minutes later)
Brief Answer:
A trial of antibiotics may be needed.

Detailed Answer:
Hello, Sir.

I understand your concern.


In case the cough is on for 1 month and is non suppressive even after 10 day therapy, its important to start a trial of antibiotics for 7 days. These antibiotics should be continued along with other medications.


I generally recommend to my patients oral tablets of levofloxaxin or moxifloxacin. l advise you to check with your pulmonologist if he shares my view and if can prescribe them to you.


Hence you please meet your doctor now and stress your needs.

Post your further queries if any.
Thank you.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Prasanna Heijebu

General & Family Physician

Practicing since :2010

Answered : 1422 Questions

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What Causes Cough Post Coronary Artery Bypass Graft Surgery?

Brief Answer: Need to rule out cardiac cause. Detailed Answer: Hi Sir, I understand your query and concern. Cough after CABG shouldn't be neglected as it may be due to Residual volume overload Post Bypass grafting or pulmonary infection. So I advise you to get a chest X ray complete blood picture ,PFT at the earliest.(if already done,upload me the reports). Once confirmed a short course of diuretics and cough suppressant s will relieve your symptoms. Continue with your present medication. I also advise you to do breathing exercises and chest physiotherapy by consulting your doctor. Post your further queries if any, Thank you.