ES Incidence and Factors Associated With Post Sternotomy Pain Syndrome in the National Heart Institute, Malaysia

Executive Summary

Incidence and Factors Associated With Post Sternotomy Pain Syndrome in the National Heart Institute, Malaysia

Arif Sudin, Rozaini Hassan

Arif Sudin, Collins Chong, Rozaini Hassan

Published: Journal of Cardiothoracic and Vascular Anesthesia. Feb 2024;38(2):466-474

Background

This study looked at people in Malaysia who had open-heart surgery in 2021 and later developed chronic chest pain—specifically a condition called Post-Sternotomy Pain Syndrome (PSPS). This type of pain sticks around for at least three months after the chest is cut open for surgery, even after the wound has healed.

Out of 1,395 patients interviewed, about 1 in 5 (20.35%) still experienced chest pain long after their surgery. Most of them described the pain as mild to moderate, but for some, it interfered with sleep, daily tasks, or emotions.

Key Findings:

 

The research team wanted to figure out why some patients developed this lingering pain and others didn’t. They found that PSPS was more likely to occur in people who:

 

    • Were under 60 years old
    • Had weaker heart function (called low “ejection fraction”)
    • Had a previous heart procedure (angioplasty or PCI)
    • Did not have chronic kidney disease (surprisingly, people with kidney problems had less post-surgery pain)

 

Interestingly, even though many patients had pain, only 1 in 6 took medication for it. This might be because they thought the pain was normal after surgery or didn’t bring it up during doctor visits.

The researchers think that nerve irritation or scarring from earlier heart procedures could make patients more sensitive to pain after open-heart surgery. Also, younger patients may feel pain more intensely due to a more active nervous system.

 

Conclusion

A significant number of patients still suffer from chest pain long after heart surgery, even if the pain isn’t always severe. Knowing who is more likely to experience this pain helps doctors identify patients who need closer follow-up or early treatment. While the pain may not be intense, it can disrupt life and emotional health. More research and better pain management strategies are needed to help people live more comfortably after surgery.