During a cardiac catheterization, a cardiologist passes a long catheter through a large artery---typically the femoral---into the heart in order to determine the health of the heart. Complications of cardiac catheterization may be life-threatening and can arise during and after the procedure. Throughout the procedure, the patient is awake and the physician and cath lab nurses monitor the patient's reactions to the procedure. After the cath, nursing staff closely monitors the patient for several hours after to ensure that the patient has suffered no complications.
Cardiac Arrhythmias
Because the catheter passes into the heart, cardiac rhythm abnormalities can occur. The physician performing the procedure will order drugs to correct the rhythm or place the patient on an external pacemaker, if necessary. After the procedure, the patient wears a heart monitor for several hours, and nurses observe the heart rate and rhythm.
Heart or Artery Damage
Although the physician uses an x-ray machine to guide the catheter to the heart, the catheter may nick an artery or injure the cardiac tissue, according to the National Heart Lung and Blood Institute. The physician can visualize such complications on a screen and respond immediately with appropriate interventions.
Infection
All invasive procedures carry risks of infection. Complications of infection with cardiac catheterization are particularly dangerous because the infection travels through an artery and directly to the heart, states Judith Schilling McCann in the book "Cardiovascular Care." Nurses monitor the patient for signs and symptoms for several hours after the procedure, and also teach the patient about what to look for and what symptoms to report after discharge from the hospital.
Site Bleeding
After removal of the catheter, a small metal or plastic device closes off the insertion site of the artery. Patients receive instructions to lie flat for several hours to prevent dislocation of the device. If the device becomes dislodged, internal bleeding may occur and result in rapid swelling at the incision site and severe pain to the patient. This situation constitutes a medical emergency and requires immediate notification of the physician.
Allergic Reaction
To better visualize circulation throughout the heart, contrast dye is injected through the catheter, according to the Cleveland Clinic. Patients may respond with an allergic reaction to the dye. The physician treats the patient with a medication designed to quickly eliminate the dye from the body.
References
- National Heart Lung and Blood Institute: Cardiac Catheterization
- Cleveland Clinic: Cardiac Catheterization
- "Cardiovascular Care"; Judith A. Schilling McCann R.N., M.S.N.; 2009
- "Critical Care Nursing"; Judith A. Schilling McCann; 2007
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