I.To determine the effect preoperative use of an Incentive Spirometer has on preventing postoperative pulmonary complications among cardiac surgical patients. III.To determine the socio-demographic and clinical factors associated with increased risk for the development of postoperative pulmonary complications following cardiac surgeries.

 Inclusion criteria:  Patients who will agree to participate in the study based on their informed consent.  Subjects with age >50 years.  Patients who undergo open heart surgery including ( coronary and valvular) procedures  Exclusion criteria:  Patients who refuse to participate in the study  thoracic, abdominal, or cerebral aneurysms  Recent cardiothoracic or abdominal surgery.