“Is chest pain after heart bypass surgery normal?”

Yes, chest ache localized to sternum is normal. Sharp, stabbing, on-off pain especially when lying down and relieved by sitting up may indicate pericarditis, which happens fairly often after bypass surgery (because they cut pericardium, a sac in which the heart sits in, open). Severe, crushing chest pain or chest pain worsening with activity would be definitely be concerning. If you feel that you may have pericarditis, which is most commonly temporary, your cardiac surgery team may prescribe an anti-inflammatory or a pain medicine. They may consider doing echocardiogram as well. So, definitely contact them. If you have severe pain, you should be checked out in person, so call your cardiac surgery team right away. If you cannot get hold of them, consider going to ER or calling 911.

The goal for bypass is to relieve angina by completely revascularizing or "bypassing" all your blockages. In some cases the arteries are too small to bypass and hybrid procedures that open up remaining blockages with balloons or stents or using medicines that either reduce demands or improve supply. If the pain is non ischemic or not related to reduced blood flow, it can be post surgical and NSAID's, pain threshold altering meds (Neurontin, SSRI 's) and for pericardial (heart sac) pain can be treated with a gout medicine, Colchicine. The way to differentiate the pain, in brief, if is similar to your pre CABG symptoms you need to see your cardiologist to discuss your options. If it is worse with deep inspiration, cough, certain positions, it is sharp if character and brief in duration it is most likely post surgical and if within a month of surgery the surgeons usually address. If after one month, your cardiologist can address.