The Prevalence and Characteristics of Shoulder Pain in Female Patients with Coronary Artery Bypass Graft (CABG)

shiva Mousavi, Behnoosh Vasaghi-Gharamaleki, Jalil Mirza-Mohammad Khanpour, Tahereh Khosravian-Arab


Background: Currently, cardiovascular disease is the most common cause of
death in the world. The current study aimed to determine the prevalence and
characteristics of shoulder pain in female patients with coronary artery bypass
graft (CABG).
Methods: This cross-sectional study enrolled 136 women after (CABG) through
easy access, and questionnaires were distributed to them. The subjects were
asked to complete the questionnaire regarding the time of incidence and
characteristics of their shoulder pain, their history of exercise, and their history
of pulmonary, cardiovascular, and other diseases. The patients’ intensity of pain
was measured using the visual analog scale (VAS).
Results: In this study, 45 patients had shoulder pain. In nearly half of the
patients, the pain began from the left shoulder, and one-third of the patients had
pain in both shoulders. Onset of pain was sudden in more than 50% of cases.
Conclusion: One-third of patients who underwent CABG suffered from shoulder
pain which appeared quickly and within less than a day. The pain was frequently
in the left shoulder or between the shoulder areas. Since the age of patients in
this study was 50+ years, if the pain persisted, the probability of incidence of
frozen shoulder is high.


Open heart surgery, Shoulder pain, Physiotherapy, Coronary artery bypass graft

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Mathers CD, Loncar D. Projections of global mortality and burden

of disease from 2002 to 2030. PLoS Med. 2006 Nov;3(11):e442.

Motlagh B , O’Donnell M, Yusuf S. Prevalence of cardiovascular

risk factors in the Middle East: a systematic review. Eur J

Cardiovas Pre Rehabil. 2009 Jun;16(3): 268 – 80.

Talaei M, Sarrafzadegan N, Sadeghi M, Oveisgharan S, Marshall

T, Thomas GN, et al. Incidence of cardiovascular diseases in an

Iranian population: The Isfahan cohort study. Arch Iran Med.


Koohi F, Salehiniya H, Hafshejani AM. Trends in mortality from

cardiovascular disease in Iran from 2006-2010. Sabzevar Univ

Med Sci. 2015 Sep-Oct; 22(4):630-8.

Naghavi M, Abolhassani F, Pourmalek F, Lakeh M, Jafari N,

Vaseghi S, et al. The burden of disease and injury in Iran 2003.

Population health metr. 2009 Jun;15:7:9.

Babaee G, Keshavarz M, Hidarnia A, Shayegan M. Effect of a

health education program on quality of life in patients undergoing

coronary artery bypass surgery. Acta Med Iran. 2007;45 (1):69-74.

American Association of Cardiovascular and Pulmonary

Rehabilitation. Guidelines for Cardiac Rehabilitation and

Secondary Prevention Programs. Champaign, Illinois: Human

Kinetics, 2004.

Eisenberg E, Pultorak Y, Pud D, Bar-El Y. Prevalence and

characteristic of post coronary artery bypass graft surgery pain

(PCP). Pain. 2001 May;92(1-2):11-7.

Chong AY, Clarke CE, Dimitri WR, Lip GYH. Brachial plexus

injury as an unusual complication of coronary artery bypass graft

surgery. Postgrad Med J. 2003 Feb; 79:84-6.

Soltanzadeh M, Latifi SM, Shirazi M, Fayazi S. Evaluation of

TENS in the pain management after coronary artery bypass

grafting in Ahwaz Golestan Hospital. Jundishapur Sci Med J.

Jun;32:51-57 (Persian).

Meyerson J, Thelin S, Gordh T, Karlsten R. The incidence of

chronic poststernotomy pain after cardiac surgery: a prospective

study. Acta Anaesthesiol Scand. 2001 Sep;45(8):940-4.

Lomi C, Westerdahl E. Physical therapy treatment after cardiac

surgery: a national survey of practice in Greece. J Clin Exp

Cardiolog. 2013 May;15;S7.

Shaw DK, Deutsch DT, Bowling RJ. Efficacy of shoulder range

of motion exercise in hospitalized patients after coronary arterybypass graft surgery. Heart Lung. 1989 Jul;18(4):364-9.

Keles Z, MURAT Zinnuroglu M, Beyazova M. Impairment

of upper trapezius branch of the spinal accessory nerve during

bypass grafting: a stretch injury? Muscle Nerve. 2010; 41(1):144-7.

Durmaz B, Kirazli Y, Atamaz F: Isolated spinal accessory nerve

palsy after coronary artery bypass: an unusual complication. Am

J Phys Med Rehabil. 2007 Oct;86:865–7.

Jones MI, Greenfield S, Jolly K; BRUM Trial Steering Committee.

Patients’ experience of home and hospital based cardiac

rehabilitation: a focus group study. Eur J Cardiovasc Nurs. 2009


Shafiei Z, Nourian K, Babaee S, Nazari A. Comparing

Effectiveness of light pressure stroking massage on pain and

fatigue of patients after coronary artery bypass graft surgery-A

randomized clinical trial. J Clin Nurs Midwifery. 2013; 2(3):


Nerbass FB, Feltrim MI, Souza SA, Ykeda DS, Lorenzi-Filho G.

Effects of massage therapy on sleep quality after coronary artery

bypass graft surgery. Clinics (Sao Paulo). 2010;65(11):1105-10.

Bagheri-Nesami M, Zargar N, Gholipour-Baradari A, Khalilian

A. The Effects of foot reflexology massage on pain and fatigue

of patients after coronary artery bypass graft. J Mazand Univ

Med Sci. 2012 Sep; 22(92): 52-62 (Persian).

Masoumi SZ, Kazemi F, Khani S, Seifpanahi-Shabani H,

Garousian M, Ghabeshi M, et al. Evaluating effect of cardiac

rehabilitation care plan on quality of life of patients undergoing

open heart surgery at Ekbatan hospital, Hammadan. Res j Med

Sci. 2017; 11(1):32-9.

Binder AI, Bulgen DY, Hazleman BL, Roberts S. Frozen

shoulder: a long-term prospective study. Ann Rheum Dis. 1984


Uddin MJ, MSAM Ahmed, M Moniruzzaman, MH Rahman, MJ

Uddin, M Siraj. Prevalence of frozen shoulder among patients

undergoing cardiothoracic surgery. Ibrahim Card Med J, 2011.


Wolf JM, Green A. Influence of comorbidity on self-assessment

instrument scores of patients with idiopathic adhesive capsulitis.

J Bone Joint Surg Am. 2002 Jul;84-A(7):1167-73.

Dehdari T, Hashemifard T, Heidarnia AR, Kazemnejad A. The

longitudinal effect of health education on health-related quality

of life in patients with coronary artery bypass surgery. Med Sci.

;15 (1):41-6 (Persian).

Abbasi M, Mohammadi N, Nasrabadi AN, Fuh SB, Sadeghi T.

Re-Birth After Coronary Bypass Graft Surgery: A Hermeneutic-

Phenomenological Study. Glob J Health Sci. 2014 May; 6(3):


Shafipour V, Moosazadeh M, Jannati Y, Shoushi F. The effect of

education on the anxiety of a family with a patient in critical care

unit: a systematic review and meta-analysis. Electron Physician.

Mar 25;9(3):3918-24.

Rosenfeldt F, Braun L, Spitzer O, Bradley S, Shepherd J, Bailey

M, et al. Physical conditioning and mental stress reduction-a

randomized trial in patients undergoing cardiac surgery. BMC

Complement Altern Med. 2011 Mar 9;11:20.

Colella TJ, King KM. Peer support. An under-recognized resource

in cardiac recovery. Eur J Cardiovasc Nurs. 2004 Sep;3(3):211-7.

Choinière M, Watt-Watson J, Victor JC, Baskett RJ, Bussières

JS, Carrier M, et al. Prevalence of and risk factors for persistent

postoperative nonanginal pain after cardiac surgery: a 2-year

prospective multicentre study. CMAJ. 2014 Apr 15;186(7):E213-23.

Varaei1 Sh, Cheraghi MA, Seyedfatemi N, Talebi M, Bahrani

N, Dehghani A, et al. Effect of peer education on anxiety in

patients candidated for coronary artery bypass graft surgery: a

randomized control trial. J Nur Edu. 2013 2(3):28-37 (Persian).


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