Heart Matters: Warning! Cardiac cath complications
Nichole Miller BSN, RN, CCRN, PCCN

$3.95 		Nursing Made Incredibly Easy!
August 2012 
Volume 10  Number 4
Pages 8 - 10
 
  PDF Version Available!

ABSTRACT
Mr. S, 48, is admitted to your ICU for an acute myocardial infarction (MI). Before this event, he has no significant past medical history. After cardiac catheterization with angioplasty and stent placement to the right coronary artery, the patient returns to the ICU for overnight observation. He's seen by the cardiologist the next morning and scheduled for transfer to the telemetry unit. Just before transfer, Mr. S starts to complain of flank pain.Your assessment finds that the patient has a small hematoma at the insertion site, increased bruising from the insertion site spreading across the thigh, and an absent pedal pulse in the right foot. You call the healthcare provider who orders a computed tomography (CT) scan and labs.Test results show that Mr. S has a retroperitoneal bleed. Anticoagulation is stopped and blood cell counts are monitored. The patient spends an extra night in the ICU for monitoring and is able to transfer the next day. Because this complication was recognized quickly, Mr. S suffers no adverse effects.Every year there are approximately 3 million cardiac catheterizations performed in the United States (see Picturing cardiac catheterization). Common indications for this procedure include the diagnosis and evaluation of coronary artery disease and acute MI, evaluation of overall cardiac function, and interventions such as angioplasty. As with all invasive procedures, there are risks involved, ranging from bleeding at the incision site to complications as severe as stroke and even death. Prevention of complications isn't always possible, but early recognition of the signs and early intervention when complications do occur has been shown to yield better patient outcomes. The key to early detection is twofold: You need to know who's at risk and how to spot a problem.Several factors have been identified that increase a patient's chance of developing a complication after cardiac catheterization: * advanced age. At age 70, the risk of developing complications

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