chest cave in

  My boss was diagnosed with cardiomyopathy and blocked arteries
  several months ago.  He is also a diabetic.
  He underwent quadruple bypass surgery
  4 months ago.  He went to all his post
  operative appointments and progressed
  normally except for an infection at the site on his leg where the vein was removed for the bypass.  He has no insurance, and has cancelled subsequent appointments, such as a repeat heart echo that was scheduled, because of financial problems.  
  His wife asked me to post a question and see if we could get some responses and some information.  His chest, where his ribs were spread for the bypass, is sort of concaved in, and
  she is concerned about this.  She feels that he went back to work too soon after the surgery and pushes himself too much, lifts too much, etc.
  To a certain degree, from my observations, she's right.  He is just a very "controlling" individual and has to have everything his way.  He simply refuses to admit that he has limits and he feels that his body
  is rebelling against him.
  Any information on cardiomyopathy
  or the matter of the caved-in appearance of his chest would be much appreciated.

[CCF CARDIO MD APS]

Dear Marsha,  As for the cardiomyopathy, there is not only a wealth of information on this subject there are also many different causes of a cardiomyopathy(CM.)  CM means that the heart muscle is weak, the most likely causes are longstanding hypertension, diabetes, multiple heart attacks, and viral causes.
There have been great advances in the past 10 years in the treatment of heart failure including new medications and surgical treatments as well.  Actually one of the medicines used is called an ace-inhibitor(examples are lisinopril,captopril,monopril)that also works to protect the kidneys from long term damage in patients with diabetes.
Most cardiomyopathy patients need close follow-up with a cardiologist or general internist that deals with this type of heart diseae a lot.  Heart Failure from CM can make a person very fatigued, have swelling in the legs, be very short of breath, as well as depressed.   Mind you that any one of these symptoms can be present alone, and it sounds like your
friend would benefit from talking with someone (social work and or psycology) that deals only with cardiac pateints so he can have al the details explained or just be taught how to control his disease instead of feeling as if it is controlling him.
As for the chest abnormality, all pateints at the Cleveland Clinic upon discharge following chest surgery are told not to lift over 10 lbs and not to drive for 6 weeks and this is because this is the amount of time it takes for the bone to heal.  Either your friends chest has healed abnormally for structural reasons or it is unstable because there is an infection
present which is more likely to occur in a diabetic.  If it is not red or oozing purulent drainage it is unlikely to be infected, however this too should be evaluted by some physician.  Information provided in the Heart Forum is intended for general informational purposes only, actual diagnosis and treatment can only be made by your physician(s).