Returning to work following CABG

Postoperative time to full activity including work for non-manual work (weeks):

Notes:

• the information applies to general fitness to work for people below 60 years of age without other significant disability - those working in than heavy manual work have suggested return to work times for CABG and angioplasty as below. However it is important to consider individual clinical circumstances when advising patients

• * This information is only a guide to doctors, who will need to consider the individual clinical circumstances when advising patients
• with respect to returning to work following a CABG:
  • Every person recovers differently and has different needs. If you do a job which involves only light physical exertion - i.e., it does not involve you standing for periods of more than 20 minutes, or lifting more than 5kg at a time - you can usually return to work 6-8 weeks after your operation. Most people will find themselves fit to work by two to three months after the operation (3)
  • An online occupational health resource suggests that (4)
    • a return to work of 12-39 weeks if "heavy manual" work
    • a return to work of 26-39 weeks if "physically demanding" work
• with respect to returning to work following a coronary angioplasty (5):
  • "..If you have had an angioplasty that was planned in advance, and there were no complications, you may be able to return to work within a few days, depending on the type of work you do. If you had an angioplasty as an urgent treatment for acute coronary syndrome, it’s likely that you will need to wait longer than this before going back to work. If you have had a heart attack, you may need to take a few weeks off work, or longer if you have a manual job."
• in most cases, returning to work after MI should not be delayed beyond 3 months as a successful return is less likely as time goes on (2)
• patients who have suffered a cardiac arrest or undergone CABG generally take longer to recover physically and cognitively and may require up to 6 months off work (2)
• cardiac rehabilitation programmes should include work assessment and advice
  • assessment may simply involve listing the tasks involved in the job and grading them in order of difficulty
  • occasionally a more detailed assessment in the work place may be required
  • where exercise tolerance is reduced or the work is physically demanding it may be helpful to undertake a programme of 'work-hardening' as part of the rehabilitation programme (2)
  • the aim should be to devise a return to work plan which will minimise the impact of symptoms such as fatigue or poor concentration, thereby increasing the confidence of both patient and employer
  • advice to the patient should include (2):
    • phased return to work beginning with alternate halfdays - a plan where the patient's work return builds up over a 2-3 week period should be encouraged
    • initially returning to light or less challenging duties
    • making provision for additional rest periods where fatigue is a known problem or return to work has been delayed
    • providing a mechanism for feedback on performance from the employer or a member of staff

Reference:

1. Department of Work and Pensions (UK), IB204 (April 2000).
2. British Heart Foundation (Factfile July 2005). Returning to work after a heart attack.
3. Royal College of Surgeons of England.
4. http://www.workingfit.com (accessed 2/12/2020)
5. British Heart Foundation. Coronary angioplasty.HIS10/0318 (8/5/2018)