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Introduction: Patients undergoing the combination coronary artery bypass graft and atrial valve replacement surgery have an average median length of stay of 7 days; however, length of stay may be drawn out due to vascular changes and other complications surrounding the surgery. These changes and complications can create difficulties with meeting physical therapy goals/outcomes for adequate function to live at home safely. The purpose of this case report is to describe the barriers that influence the physical therapy management for an individual following a coronary artery bypass graft and atrial valve replacement. Case Description: The patient was a 65 year old male at a Midwest medical center presenting to physical therapy with mobility deficits after cardiac surgery. Mobility deficits persisted for a longer duration than typical due to perioperative complications despite being seen by physical therapy twice daily while in the hospital. Clinical Outcomes: Outcome measures used included maximal walking distance, stair ability, and Section GG scores. Discussion: Orthostatic blood pressure, pleural effusion, and atrial fibrillation are all common perioperative complications that may arise after cardiac surgery. The physical therapist in the inpatient setting must be acutely aware of the effect that these complications may have on physical therapy interventions as well as expected prognosis, monitoring vital signs during the session and completing a thorough chart review before every session. Patient safety is of the utmost important during physical therapy encounters and is affected directly by the surgery as well as the medical management afterwards.