Upper chest pain still exists after 10 weeks post surgery

@mocgreen What you’re describing actually makes a lot of sense after this kind of surgery. When they repair the ascending aorta, they spend a lot of time working in the very top of the chest—right behind the breastbone and up toward the base of the neck. Even after the sternum itself settles down, the deeper tissues up there are still healing and adjusting. A lot of people feel strange sensations in that exact area for a while.

That “stuck” or “pulling” feeling inside the upper chest is something many of us notice as the swelling goes down and the scar tissue inside the chest starts loosening up. It can feel like the inner layers are sliding around or separating again as everything settles back into place. It’s not the bone—it’s the soft tissue healing and reorganizing itself. The area right under the neck is also where the collarbones meet the sternum, and those joints get pulled pretty hard during surgery when the chest is opened. Even after the main incision pain fades, that upper chest region can stay sore or tight for a while. The key things to watch for are symptoms that are clearly worsening, sharp pain with breathing, fever, redness or swelling at the incision, or instability of the sternum. But the kind of deep tissue pulling sensation you described is very commonly part of the healing process. The body went through a massive operation. Even when the bones feel better, the connective tissue and nerves are still remodeling for months afterward.

I went through a Type A aortic dissection in 2015 and had emergency open-heart surgery with a Dacron graft placed in my ascending aorta. My sternum pain faded fairly quickly, but that upper chest tightness and pulling feeling stuck around longer. It slowly improved as the weeks went by and everything inside continued healing. Even after nearly 11 years, I still have little pings and weird pains occasionally where I had tubes, sutures, etc. Ten weeks is still pretty early in the grand scheme of recovery from this surgery. The outside often heals faster than the deeper tissues. Many of us notice those odd internal sensations for a few months as the body finishes settling down. The encouraging part is that what you’re describing sounds very familiar to a lot of people who’ve gone through the same operation. Peace.

@moonboy, your response, advice, and "voice of experience" were just what I needed today! Whenever I shared my feelings with the docs, they would say "it's the healing process" but I have never received as thorough a response as you provided. Thank you from the bottom of my heart!

Frankly, the docs don't understand it unless they themselves have had open heart surgery. I love my docs BUT they don't REALLY understand what I have been through unless they have been through it themselves. Another thing that sometimes explains a slower or more uncomfortable recovery is whether the surgery was planned or done as an emergency. When surgery happens because of an acute aortic dissection, everything moves very fast. The goal in that situation is simple and urgent: save the patient’s life. The surgical team does an incredible job, but the circumstances are very different from a scheduled aneurysm repair where the operation can be carefully planned ahead of time and you can prepare yourself for it.

With a dissection, the tissues of the aorta are already torn and extremely fragile. Surgeons often have to work quickly in a very inflamed area, and sometimes the tear extends farther than expected once the chest is opened. That can mean more manipulation of the upper chest, the aortic arch, and the surrounding structures while they stabilize everything and replace the damaged section with the graft. Because of that urgency, there can be more swelling, more tissue trauma, and more internal irritation afterward. The body has essentially gone through both a catastrophic event and a major surgery at the same time. That combination can make the recovery feel rougher or take longer compared to a planned operation.

I experienced this firsthand when I had a Type A aortic dissection that required emergency open-heart surgery and placement of a Dacron graft in my ascending aorta. The surgeons had to move quickly because time really matters in those situations. My sternum healed on schedule, but some of the deeper chest sensations and tightness hung around longer while everything inside settled down. So if your operation was done urgently because of a dissection, some extra aches, tightness, or strange sensations in the upper chest during the first few months can simply be part of the body recovering from a very dramatic event. It's going to take several months before you start feeling anything close to normal. My wife tells me that I was not back to my regular self for at least 2.5 years. Today? I feel great 11 years out.

Its been a year and a half since surgery for me. My chest has finally started feeling more normal the past couple of months. I still hate sneezing. Two weeks ago I went to Mayo and had a nuclear stress test done because of some acute pain that showed up that was more like the pre-surgery pain. Everything seemed o.k.

@moonboy
Thanks for your comments!
I am waiting for surgery to be scheduled for my thoracic aortic aneurysm and reading the comments about recovery has me concerned. I go to a gym and pay for a trainer who has me doing exercises for balance and strength (I am 81 years old) Planking, stomach crunches, squats, are some of more taxing exercises. My thoracic surgeon said I should stop those exercises, but after my surgery, I can continue with them. He gave me the impression I could start the exercises almost immediately after "recovery"......I assume 3 - 4 months. From the comments here, it sounds like his comment is untrue. Any replies would be appreciated.

All I can do is share my experience with emergency open heart surgery following a sudden aortic dissection. It was my thoracic ascending aorta. The recovery was substantial at age 50. I was not really myself for probably two years. I am 61 now and feel better than I did before the surgery although it’s been 11 years. I don’t know what your experience will be but I think three or four months is unrealistic unless your thoracic surgeon himself has had open-heart surgery and recovered from it in three or four months. I will say this that I was back to work within six weeks, but I was not driving for the first few months, and I was generally a mess for at least the first year. Again, I had an emergent dissection so that may have made a difference, but I have to be candid with you. I think 3 to 4 months to recover at 81 is pretty optimistic and I don’t think realistic. The other thing you need to realize is that you need a trainer who has expertise in cardiac rehab. Just your run-of-the-mill trainer is not appropriate because I had one after my surgery and he tried to make me do planking and forced me to run on a treadmill beyond my ability. After you have a dissection that’s repaired, your job is to get better and that’s a slow and steady effort. I did a lot of walking, and that helped quite a bit, but I would never go back to planking or dead, lifting or grunting of any kind. Again, I’m presuming that they are going to put an aortic graft in your chest and I think that the days of pounding grinding, grunting and planking in the gym are over. That doesn’t mean you can’t do cardio, it just means that you cannot do things that jack your blood pressure up. I’d be very cautious about any advice to be back in the gym at three months. I had trouble carrying a pillow from the car to the lake house at four months. Depending on how good shape you’re in and how well the surgery goes, you could have a longer recovery than 3 to 4 months. I would plan on it. Peace.