Abstract: Background: Open heart surgery is one of the recommended treatments for cardiovascular disease. Post open heart surgery, patients experience moderate to severe dyspnea, pain and hypoxemia. Purpose: To evaluate the effect of pulmonary strategies on pulmonary function, dyspnea and pain among high risk patients post open heart surgery.  Setting:  Current research was conducted at the Cardiothoracic Surgical Intensive Care Unit (ICU) and Cardiothoracic Surgical Department in Menoufia University Hospital. Sample: A purposive sample of sixty patients was obtained. Design: A Quasi-experimental design was used. Instruments: 1) Demographic and Medical Data Questionnaire; 2) Visual Analogue Pain Scale (VAS); 3) Dyspnea Severity Score Scale; 4) Bio physiological Measurements. Results: There was a highly statistically significant improvement in the total mean score of pulmonary function (FVC, FEV1, and FEV1/FVC) in the study group compared to the control group (P < 0.000) post-intervention. After the intervention, the study group experienced significantly lower severity of dyspnea than the control group (P = 0.001). Additionally, the study group exhibited significantly reduced mean pain intensity scores compared to the control group (P = 0.001) post-intervention. Conclusion: Pulmonary strategies are effective in improving pulmonary function, reducing dyspnea episodes and pain intensity post open heart surgery. Recommendation: Using pulmonary strategies as a routine hospital care to improve pulmonary function, dyspnea and pain post open heart surgery.