post cardiac cath

Hi,

I was wondering if there are any possible conditions that could arise post-cardiac cath? A few things in question: Is the patient at an increased risk of thrombus due to the procedure? I see some interventional cardiologists order Lovenox post procedure, but others do not. What about a decreased potassium level? Is that common?

[ghillbert, MSN, NP]

Usually a bleeding risk rather than thrombosis - apart from risk of reocclusion of a coronary vessel, or formation of a hematoma at the groin access site.

Risk of arrhythmias, renal problems due to the dye used.

Don't know that it causes a low k (although you encourage fluids postop to flush the kidneys so you might get a relative hypokalemia I guess).

[highlandlass1592, BSN, RN]

Lots of things can happen post cath: you could develop a hematoma which could be significant enough to impair circulation, retroperitoneal bleed, kidney failure (especially if no prep was done to protect the kidneys), reocclusion of coronary vessels, bradychardia when sheaths are pulled and other arrthymias. I've not seen post cath lyte disturbances solely from the cath, usually they are from not being corrected pre-procedure. Stroke is also a risk post-cath, if some plaque breaks off and travels you can be in trouble (I've had that happen a couple of times). Thrombocytopenia can develop due to post-procedure meds. Those are the few I can think of off the top of my head.

[MissAnthrope]

My very first code blue ever as a nurse was a post cath pt. The wire had perforated the artery (unsuccessful angioplasty attempt). It was small enough, but large enough at the same time, that he got back to his room, and to me, was there for thirty minutes complaining of nausea and chest pain, then went asystole due to a tamponade. (Lesson learned was, if a pt says they feel like they're dying, listen up!) He went to OR and did survive, thankfully.

That's probably one of the most rare complications I can think of, but the most serious. Leave it to my unique luck to have it be my first experience with calling a code, and assisting with a chest crack all in one...

[cardiaccrn]

One of the main problems arising from a diagnostic coronary angiogram is bleeding from the

arterial site. We observe the patient closely post procedure for this. SeK+ does not tend to

change due to the procedure, but should be monitored to ensure it is within normal limits. Contrast

dye can cause renal impairment, thus affecting the K+. For all angiograms there is a 0.1% chance of

MI, stroke and death. Stroke can be caused by dislodgment of LV thrombus during an LV gram or

from cholesterol emboli being dislodged from the arterial wall (usually the aorta).

[celclt]

neurovascular issues in groin access leg- remember your P"s=pallor, pain, pulselessness, paresthesia, paralysis

[dagne1984]

Also Vagaling.