Post CABG and hypertension

Specialties Cardiac

Published

Hi, I'm a student nurse. I was wondering why hypertension post CABG is important to control. What signs other then BP contribute to it being a concern. How should hypertension post op be controlled.

From my readings, it seems like HYPOtension is the more concerning vital sign.

Can someone please explain this to me.

Thank you

Advanced Practice Columnist / Guide

Corey Narry, MSN, RN, NP

8 Articles; 4,362 Posts

Specializes in ACNP-BC, Adult Critical Care, Cardiology.

Hypertension after a CABG is just as concerning. Typically, coronary artery grafts are obtained using a free saphenous vein that is sutured into the ascending part of the aorta on one end and distal to the site of an occluded coronary artery on the other end. The aorta is a high pressure vessel. Hypertension can produce such a high pressure in the aorta to cause to aortic suture to weaken and leak out blood. That is a surgical emergency if that should happen. HTN also makes the newly placed sutures in the fresh post-op heart and great vessels prone to bleeding from any of the cannulation sites used in cardiopulmonary bypass. This would cause a high output in the chest tubes concerning for a surgical emergency as in the other scenario.

Advanced Practice Columnist / Guide

Corey Narry, MSN, RN, NP

8 Articles; 4,362 Posts

Specializes in ACNP-BC, Adult Critical Care, Cardiology.

Institutions vary on BP control after CABG. Typically, the standard is to use a short acting agent given as a drip. I've seen Nitroglycerine, Nitroprusside, and Nicardipine used.

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