A Rare Case of Post Coronary Artery Bypass Grafting Sternalis Syndrome with Myokymia and Its Physiotherapy Management

Sternalis syndrome is a rare musculoskeletal condition characterized by severe chest pain localized to the sternum and is often misdiagnosed due to its resemblance to cardiac disorders. Myokymia, defined as undulating, wavelike rippling of muscle fibers, is a manifestation of peripheral nerve hyperexcitability and can complicate the presentation of sternalis syndrome. We report the case of a 50-year-old male with persistent deep sternal pain and involuntary chest wall movements for several years following coronary artery bypass grafting (CABG). The physiotherapy intervention included trigger point release, transcutaneous electrical nerve stimulation (TENS), stretching, thoracic expansion, and cervical spine exercises. Outcomes were evaluated based on pain severity, quality of life, cervical range of motion, myofascial trigger points, and abnormal involuntary movement scale frequency. Significant reduction in pain and involuntary movements was observed post-intervention, highlighting the effectiveness of physiotherapy in managing post-CABG sternalis syndrome with myokymia.