cardiovascular disorders
Cardiac Catheterization
Complications of Cardiac Catheterization
The incidence of complications after cardiac catheterizations ranges from 0.8 to 8%, depending on patient factors, technical factors, and the experience of the operator. Patient factors that increase risk of complications include Chronic Kidney Disease None Chronic Obstructive Pulmonary Disease (COPD) (COPD) Diabetes Mellitus (DM) None Heart Failure (HF) None Increasing age Peripheral Arterial Disease None Overview of Cardiac Valvular Disorders None Most complications are minor and can be easily treated. Serious complications (eg, Cardiac Arrest , In general, complications involve The contrast agent Effects of the catheter The access site Injection of radiopaque contrast agent produces a transient sense of warmth throughout the body in many patients. Tachycardia, a slight fall in systemic pressure, an increase in cardiac output, nausea, vomiting, and coughing may occur. Rarely, bradycardia occurs when a large amount of a contrast agent is injected; asking the patient to cough often restores normal rhythm. (see also Radiographic Contrast Agents and Contrast Reactions ) include Allergic-type contrast reactions Contrast-induced kidney injury 50 mg IV. Anaphylaxis and Contrast Nephropathy None 1.Wang CL, Cohan RH, Ellis JH, et al: Frequency, outcome, and appropriateness of treatment of nonionic iodinated contrast media reactions.AJR Am J Roentgenol191:409–415, 2008. doi: 10.2214/AJR.07.3421 If the catheter tip contacts the ventricular endocardium, ventricular arrhythmias commonly occur, but ventricular fibrillation is rare. If it occurs, Defibrillation (DC cardioversion) is administered immediately. Disruption of an atherosclerotic plaque by the catheter can release a shower of atheroemboli. Emboli from the aorta may cause Overview of Stroke or Coronary artery dissection is also possible. Access site complications include Bleeding Hematoma Pseudoaneurysm Arteriovenous (AV) fistula Limb ischemia Bleeding from the access site may occur and usually resolves with compression. Mild bruises and small hematomas are common and do not require specific investigation or treatment. A large or enlarging lump should be investigated using ultrasonography to distinguish hematoma from pseudoaneurysm. A bruit at the site (with or without pain) suggests an AV fistula, which can be diagnosed using ultrasonography. Hematomas usually resolve with time and do not require specific therapy. Pseudoaneurysms and AV fistulas usually resolve with compression; those that persist may require surgical repair. Radial artery access is in general more comfortable for the patient and carries a much lower risk of hematoma or pseudoaneurysm or AV fistula formation when compared with femoral artery access. 