z` Q A 93-year-old female with a medical history significant for severe aortic stenosis (EF 60-65%) and scheduled for transcatheter aortic valve replacement, presented to the ED complaining about pain and swelling in her right wrist after a transradial cardiac catheterization performed as part of transcatheter aortic valve replacement evaluation. The cardiac catheterization procedure itself generally takes 30 minutes, but the preparation and recovery time add several hours to your appointment time (five to nine hours or longer). %%EOF In either case, theyll monitor you for several hours after the procedure. The quality of the evidence describing these complications is poor as many studies are underpowered and do not report any events. What is the number to call? Mayo Clinic College of Medicine and Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Graduate Medical Education, Mayo Clinic School of Continuous Professional Development, Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Financial Assistance Documents Minnesota, Assortment of Health Products from Mayo Clinic Store, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition, Pulmonary atresia with intact ventricular septum, Pulmonary atresia with ventricular septal defect, Spontaneous coronary artery dissection (SCAD), Locate narrowing or blockages in the blood vessels that could cause chest pain (angiogram), Measure pressure and oxygen levels in different parts of the heart (hemodynamic assessment), See how well the heart pumps blood (right or left ventriculogram), Take a sample of tissue from your heart (biopsy), Diagnose heart problems present from birth (congenital heart defects), Examine the blood vessels for blood clots, Widening a narrowed artery (angioplasty) with or without stent placement, Treating irregular heart rhythms with cold or heat energy (cardiac ablation), Closing holes in the heart and repairing other congenital heart defects, Opening narrowed heart valves (balloon valvuloplasty), Repairing or replacing heart valves (heart valve surgery), Damage to the artery, heart or the area where the catheter was inserted, Allergic reactions to the contrast dye or medication. Sudden confusion, trouble speaking or understanding. The electrodes attach to an electrocardiograph monitor (ECG), which monitors your heart rate and rhythm. In other words, you shouldnt sit in a bathtub or pool or go swimming for one week. You may shower 24 hours after the procedure. Your provider will inject a numbing medicine underneath your skin with a small needle. The catheter can be inserted in either the wrist or groin for this procedure. As with most procedures done on the heart and blood vessels, cardiac catheterization has some risks. You may opt-out of email communications at any time by clicking on endstream endobj 201 0 obj <. Careers. Evaluate or confirm the presence of coronary artery disease. During a cardiac catheterization, your healthcare provider puts a long, narrow tube (catheter) into a blood vessel in your leg or arm and moves it to your coronary arteries. Complex regional pain syndrome (CRPS) is a disease with unclear pathophysiology. Kontopodis N, et al. Sleeping is difficult as well as I can't rest it anywhere without pain. Mamas MA, Anderson SG, Ratib K, Routledge H, Neyses L, Fraser DG, Buchan I, de Belder MA, Ludman P, Nolan J. Arterial access site utilization in cardiogenic shock in the United Kingdom: is radial access feasible? The health education materials accessed through this site are not a substitute for professional medical advice, diagnosis, or treatment. Thanks much! In: Kern's Cardiac Catheterization Handbook. In a true aneurysm, the vessel wall weakens and bulges. Mayo Clinic does not endorse companies or products. Sticky patches (electrodes) will be placed on your chest to monitor your heartbeat before, during and after the procedure. An angioplasty opens your coronary artery, increasing blood flow to your heart. 2021 Sep 1;11(9):1596. doi: 10.3390/diagnostics11091596. Hand dysfunction may occur post transradial catheterisation and majority of symptoms resolve without any clinical sequel. 24/7 visits - just $44! Dont try to sit or stand until your provider tells you it is safe to do so. Zwaan EM, IJsselmuiden AJ, van Rosmalen J, van Geuns RM, Amoroso G, Moerman E, Ritt MJ, Schreuders TA, Kofflard MJ, Holtzer CA. The search results were reviewed by two independent judicators for studies that met the inclusion criteria and relevant reviews. You may be fully awake or lightly sedated, or you may be given general anesthesia (fully asleep). A robe to wear as you wait for the procedure. Then have your family member drive you home the next morning after you have rested. Unable to load your collection due to an error, Unable to load your delegates due to an error. Kwok CS, Khan MA, Rao SV, Kinnaird T, Sperrin M, Buchan I, de Belder MA, Ludman PF, Nolan J, Loke YK, et al. Cruden NL, Teh CH, Starkey IR, Newby DE. Keep all of your follow-up appointments with your provider and make sure you keep taking your medicines. Place a stent to open a blockage in an artery. An official website of the United States government. I have a painful wrist and upper arm on my right hand. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. and transmitted securely. Cardiac catheterization is not considered a surgical procedure because your provider wont make a large incision. After you are monitored for several hours, you may go home or may need to stay in the hospital overnight. The band may be removed in 2 hours or when your wound stops bleeding. National Heart, Lung, and Blood Institute. Ludwig J, Achenbach S, Daniel WG, Arnold M. The transradial approach. The digital photographs of the contrast material allow your provider to identify the site of the narrowing or blockage in the coronary artery, evaluate the size and shape of heart chambers and/or blood vessels and find abnormal leaks or holes. If we combine this information with your protected Mamas MA, Nolan J, de Belder MA, Zaman A, Kinnaird T, Curzen N, Kwok CS, Buchan I, Ludman P, Kontopantelis E. Changes in Arterial Access Site and Association With Mortality in the United Kingdom: Observations From a National Percutaneous Coronary Intervention Database. Many neurological injuries are known to be transient and resolve over time. Many of these studies are poorly conducted and subjective reports of sensory/hand dysfunction with only few studies quantifying any changes in a robust manner. AskMayoExpert. The majority of studies that reported cases of neurological deficits following TRA were underpowered[26,29,37]. Kiemeneij F, Laarman GJ. Youll need to drink plenty of liquids to clear the contrast material from your body. 2015 Jan;94(3):e422. Agostoni P, Zuffi A, Biondi-Zoccai G. Pushing wrist access to the limit: homolateral right ulnar artery approach for primary percutaneous coronary intervention after right radial failure due to radial loop. [Appearance of complex regional pain syndrome after intramedullary nailing of a clavicle fracture]. Kwok CS, Rashid M, Fraser D, Nolan J, Mamas M. Intra-arterial vasodilators to prevent radial artery spasm: a systematic review and pooled analysis of clinical studies. 1-ranked heart program in the United States. Only specialized hospitals and research centers have these imaging procedures. Cardiac cath vs. 64 slice cat scan--which tells what? However, the cardiologist failed to mention that, because the artery in the wrist is so much smaller, the procedure can cause it to become irritated and inflamed. The area where the catheter was inserted may feel sore for a few days. Talk to a doctor now . for 24 hours. health information, we will treat all of that information as protected health Keep all of your follow-up appointments with your provider and make sure you keep taking your medicines. Diagnose you with a condition that requires surgery. We searched MEDLINE and EMBASE on 23 August 2016 using the search terms: [(radial or transradial or radial artery) AND (catheterisation or catheterization or angiography or angiogram or angioplasty or percutaneous coronary intervention or PCI)] AND (hand function or grip strength or disability or dysfunction or sensation or paraesthesia or paralysis). A nurse or technician may shave the hair from the site where the catheter will be inserted. It's guided to the heart. Find that your heart is working well after previous treatment and you dont need additional treatment. BCTQ questionnaire comprises of a symptom severity scale and a functional status scale (Table (Table6).6). Which of the following symptoms of cold intolerance do you experience in your injured limb on exposure to cold? For example, your provider could fix a heart flaw you were born with or replace your heart valve without making a large incision and doing traditional surgery. AuntNanc. Also, how long did your pain last? Your family member can retrieve these items from your car when you need them. The trigger factors include carpal tunnel release, Dupuytren's repair, tendon release procedures, knee surgery, crush injury, ankle arthrodesis, amputation, and hip arthroplasty. . For something that takes more time, like a lab analysis of a tissue sample, it might take a few days to get results. For instance, the follow up of assessment varied from anytime between the day procedure was undertaken up to a year post TRA. There were no restrictions based on language, sample size or method of assessing hand function which included disability, nerve damage, motor or sensory loss. I have a cracking painful wrist. Send a tissue sample of your heart muscle to the lab for a biopsy. Radial Artery Occlusion After Transradial Interventions: A Systematic Review and Meta-Analysis. If your providers decide to do an intervention, such as an angioplasty, that can take longer sometimes a couple of hours. If cardiac catheterization was done to diagnose a heart condition, your doctor should explain the results to you. Access and non-access site bleeding after percutaneous coronary intervention and risk of subsequent mortality and major adverse cardiovascular events: systematic review and meta-analysis. An interventional procedure (also called angioplasty) is a nonsurgical treatment that opens narrowed coronary arteries to improve blood flow to the heart. During your procedure, tell your provider if you feel: With the ability to put other devices at the end of the catheter, your healthcare provider may combine an interventional procedure with your cardiac catheterization. The contrast material outlines the vessels, valves and chambers. hbbd```b``3@$lh"E|0 I`#0;L`l0i&6` RH29i L $[v)_L@GJg` Mild to moderate skin reactions (like a sunburn) from X-ray exposure. Patients were assessed at 1 and 3 mo either clinically or via telephone reported no nerve injury. A specialist will insert an IV into your forearm or hand and give you a medication called a sedative to help you relax. Click here for an email preview. Elsevier; 2019. https://www.clinicalkey.com. 8600 Rockville Pike A specially trained cardiologist and a team of cardiology fellows, nurses and technicians will perform your cardiac catheterization in the cardiac catheterization laboratory. Blood leaking from the vessel collects in surrounding tissue. A plastic sheath is passed into this opening to allow your doctor to insert the catheter. When the contrast material goes into your heart, you may feel hot or flushed for several seconds. Senior Member. sharing sensitive information, make sure youre on a federal what to do? Wu SS, Galani RJ, Bahro A, Moore JA, Burket MW, Cooper CJ. 2016 Aug;95(31):e4388. Cardiac catheterization (also called cardiac cath or coronary angiogram) is an invasive imaging procedure that allows your doctor to look at your coronary arteries to diagnose coronary artery disease. Do Not Sell or Share My Personal Information. government site. 11 Do you have difficulty with the grasping and use of small objects such as keys or pens. Your provider can perform an interventional procedure during a diagnostic cardiac catheterization when they find a blockage, or they may schedule it after a catheterization confirms the presence of coronary artery disease (narrowing or blockage of your hearts arteries). The contrast material outlines the vessels, valves and chambers. The latest information about heart & vascular disorders, treatments, tests and prevention from the No. Cardiac catheterization is not considered a surgical procedure because your provider wont make a large incision. Sorajja P, et al. McGraw Hill; 2017. https://accessmedicine.mhmedical.com. Arm pain was assessed by . Failed my ekg and cst but cardiac cath was fine. You may not notice it until days or weeks after the procedure. information highlighted below and resubmit the form. choices but what the doctors find may require some adjustments. 200 0 obj <> endobj 1-ranked heart program in the United States. Brachial, radial, or femoral approach for elective Palmaz-Schatz stent implantation: a randomized comparison. Ball WT, Sharieff W, Jolly SS, Hong T, Kutryk MJ, Graham JJ, Fam NP, Chisholm RJ, Cheema AN. Tharmaratnam D, Webber S, Owens P. Adverse local reactions to the use of hydrophilic sheaths for radial artery canulation. Cardiac catheterization gives doctors important information about the heart muscle, heart valves and blood vessels in the heart. van Leeuwen MA, van Mieghem NM, Lenzen MJ, Selles RW, Hoefkens MF, Zijlstra F, van Royen N. The effect of transradial coronary catheterization on upper limb function. McGraw Hill; 2019. https://accessmedicine.mhmedical.com. If the catheter was placed in the groin area, you may need to lie flat for several hours after the procedure to avoid serious bleeding and to allow the artery to heal. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Calcium supplements: A risk factor for heart attack? Your healthcare provider has to keep the air cool to prevent damage to the X-ray machinery they use during the procedure. Your doctor should discuss whether this is a possibility before the procedure begins. CISS: Cold intolerance symptom severity; EMG: Electromyography. Patients were asked to describe any procedure-related extremity complaints or loss of function at 1 mo, Temporary upper limb complaint (< 30 d): 26/286 (9%) Persisting upper limb complaint (> 30 d): 31/286 (11%) Pain: 13/286 Numbness: 2/286 Tingling: 3/286 Stiffness: 2/286 Less power: 2/286 Upper limb function by QuickDASH at 30 d: No change over time, baseline 4.55 (IQR 0-13.64), follow up 2.27 (IQR 0-9.32) Upper limb function by CISS at 30 d: No change over time Upper limb function by QuickDASH at 1 yr: no change over time, baseline 2.39 (IQR 0-13.64), follow up 0 (0-11.02) Cold intolerance was not associated with access route at 1 yr, Ultrasound assessment for radial artery occlusion, aneurysm or dissection. Youll lie on a special table. You can usually drive 24 hours after leaving the hospital. Our search yielded 555 related studies out of which after screening and reviewing the full manuscripts, 13[24,26-38] studies were included in the final review. Jameson JL, et al., eds. Prull MW, Brandts B, Rust H, Trappe H. Vaskulre Komplikationen der perkutanen transradialen Koronarangiographie und Koronarintervention. Spaulding C, Lefvre T, Funck F, Thbault B, Chauveau M, Ben Hamda K, Chalet Y, Monsgu H, Tsocanakis O, Py A, et al. About your pacemaker implantation. Before Your cardiologist will discuss the specific risks and potential benefits of the procedure with you. Whereas Zwaan et al[25] reported a pooled incidence of 0.32% in 14 studies evaluating hand dysfunction post TRA. Pain Following Cardiac Cath Through Wrist. Revealing the impact of local access-site complications and upper extremity dysfunction post transradial percutaneous coronary procedures. Hassell ME, Piek JJ. If the catheterization is done through the radial artery, the following guidelines must be followed: Do not move your wrist more than you need to for 24 to 48 hours after the procedure. Correspondence to: Dr. Muhammad Rashid, MBBS, MRCP, Keele Cardiovascular Research Group, Keele University, Thornburrow Drive, Hartshill, Stoke-on-Trent ST4 7QB, United Kingdom. The incidence of hand dysfunction defined as disability, grip strength change, power loss or any other hand complication was incredibly low at 0.26%[24,30,32,33,37,39]. Accessed Sept. 8, 2021. Accessed Sept. 6, 2021. Cardiac Catheterization Risks and Complications. Rashid M, Kwok CS, Pancholy S, Chugh S, Kedev SA, Bernat I, Ratib K, Large A, Fraser D, Nolan J, et al. Thoracic aneurysms and aortic dissection. Your provider will use an X-ray camera to take photographs of your arteries and heart chambers while the contrast is flowing through them. By using our website, you consent to our use of cookies. For instance, van Leeuwen et al[24] reported that almost 20% patients developed subjective neurological complications in the form of numbness, tingling, stiffness and less power, more importantly nearly 50% resolved by 30 d at follow up. You may be asked to remove dentures and any jewelry, especially necklaces that could interfere with pictures of the heart. Theyll check your bandage regularly, but call your provider if you think youre bleeding (have a wet, warm sensation) or if your toes begin to tingle or feel numb. Mitchell R, Chesney A, Seal S, McKnight L, Thoma A. Anatomical variations of the carpal tunnel structures. 2018; doi:10.1093/europace/eux274. Too much fat can also cause problems. The clinical significance of neurological and motor injuries leading to hand dysfunction must be considered. The .gov means its official. Finally, current literature does not provide an insight around the prevalence and significance of lower limb function in patients undergoing transfemoral access. Handgrip strength by Jamar Plus dynamometer. An official website of the United States government. Journal of the American Society of Echocardiography. 13th ed. Causes of Pain After Cath Procedures. The amount of sedation needed for the procedure depends on your health conditions and why you're having the procedure. This type of catheteriziation is done through an artery in the patient's wrist. Mouawad NJ, Capers Q, Allen C, James I, Haurani MJ. You may be asked to use the toilet to empty your bladder. Your provider will numb the catheter insertion site with a local anesthetic. We evaluated the extent of non-ischemic arm pain after transradial arterial access and identify variables that may be associated with this complication. Depending on where the catheter was put into your body, youll need to avoid strenuous activities (including sports and lifting) for two to five days. Hulme W, Sperrin M, Rushton H, Ludman PF, De Belder M, Curzen N, Kinnaird T, Kwok CS, Buchan I, Nolan J, et al. Evaluate for coronary atherosclerosis. Characterization of operator learning curve for transradial coronary interventions. Europace. A family member with you to wait with you before the procedure. Do not push or pull with your arm. This handout gives care instructions to follow for the first few days after having a cardiac catheterization using the transradial approach. I have been on Warfarin for many many years and, until a year and a half ago when I suffered multiple clots in my lungs, my dose was very stable and seldom altered, no matter what I ate. Epub 2019 May 30. Once it is in place, several diagnostic and treatment procedures can be done using catheterization. The bibliographies of included studies and relevant reviewers were screened for additional studies. Is poststroke complex regional pain syndrome the combination of shoulder pain and soft tissue injury of the wrist? Created for people with ongoing healthcare needs but benefits everyone. TRA: Transradial access; TFA: Transfemoral access; PCI: Percutaneous coronary intervention; UED: Upper Extremity dysfunction. Youll need to make your provider aware of any medicines youre taking and any allergies you have. Higher quality studies with clinically relevant endpoints are needed to better understand the incidence and clinical significance of the hand dysfunction following TRA. European Journal of Vascular and Endovascular Surgery. Your provider will start an intravenous (IV) line in your arm so you can receive medications and fluids during the procedure. Treat your wrist . Zwaan EM, Koopman AG, Holtzer CA, Zijlstra F, Ritt MJ, Amoroso G, Moerman E, Kofflard MJ, IJsselmuiden AA. Cleveland Clinic is a non-profit academic medical center. Advertising revenue supports our not-for-profit mission. Some hospitals have a medical concierge to help you make arrangements. The idea, which makes intuitive sense, is that if a signi Dr. John Szawaluk and another doctor agree. Your healthcare provider will remove the catheters and sheath after your procedure. For example, your doctor may recommend this procedure if you have irregular heartbeats (arrhythmias), chest pain (angina) or heart valve problems, among other things. Contact your healthcare provider if you have: If you feel youre having a heart attack or stroke, get help right away. Complex Regional Pain Syndrome Type I Following Non-Orthopedic Surgery: Case Report and Narrative Review. Find and fix a blockage in your coronary artery. Once it is in place, several diagnostic and treatment procedures can be done using catheterization. Similarly there was no change in the CISS score over time. Transradial cardiac catheterization is a procedure used to treat and diagnose certain heart conditions. Last reviewed by a Cleveland Clinic medical professional on 04/29/2022. I'm wondering if anyone else has had this same problem and what you did to treat the pain. Adequately powered randomized trial with a control group is required to better understand the incidence and mechanisms involved in the development of hand dysfunction post TRA. Allergic reaction to the medication or contrast material you received during the procedure. It is unclear what factors are associated with hand dysfunction after TRA. Pseudoaneurysms and arteriovenous fistulas. Last reviewed by a Cleveland Clinic medical professional on 04/29/2022. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Dont try to sit or stand until your provider tells you it is safe to do so. Detail process of inclusion and exclusion is illustrated in Figure Figure11. McGraw Hill; 2018. https://accessmedicine.mhmedical.com. Bookshelf To provide you with the most relevant and helpful information, and understand which Youll lie on a special table. Elsevier; 2020. https://www.clinicalkey.com. Cardiac catheterization provides valuable information your healthcare provider can use to decide what treatment would be best for you. Visual analogue scale is measure of pain intensity on a continuous scale anchored by pain descriptor ranging from no pain (0 score) to worst pain (score 10)[41]. Theyll insert a plastic introducer sheath (a short, hollow tube through which they place the catheter) in a blood vessel in your arm, neck or groin. official website and that any information you provide is encrypted Cardiac catheterization procedures can both diagnose . During your drive home, stop every hour and walk for five to 10 minutes. Send a tissue sample of your heart muscle to the lab for a biopsy. Methods: We performed a retrospective analysis of a 1706 patient database on patients who underwent transradial catheterization at three experienced radial centers. But, when the outpatient surgery center called to check on me shortly after, they advised cold, instead, to help reduce the inflammation. what can i do. MeSH Accessibility However, some common risks include bleeding or bruising. Before you go home, theyll talk with you about your treatment, including medications, diet and future procedures. Overview. 14th ed. Ask your healthcare provider when you can resume driving and exercising. Hamon M, Pristipino C, Di Mario C, Nolan J, Ludwig J, Tubaro M, Sabate M, Mauri-Ferr J, Huber K, Niemel K, et al. Leave all valuables at home or with a family member. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://medlineplus.gov/ency/article/003419.htm), (https://www.nhlbi.nih.gov/health-topics/cardiac-catheterization). Theyll insert a plastic introducer sheath (a short, hollow tube through which they place the catheter) in a blood vessel in your arm, neck or groin. Just before transfer, Mr. S starts to complain of flank pain. You will get a mild sedative to relax you, but youll be awake and conscious during the whole procedure. In view of the limited published data we conducted a systematic review to evaluate the hand dysfunction post TRA. Your doctor should go over this with you. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. August 10, 2021. Your provider will let you know how long before your procedure you should stop eating and drinking. Valgimigli M, Gagnor A, Calabr P, Frigoli E, Leonardi S, Zaro T, Rubartelli P, Briguori C, And G, Repetto A, et al. After cardiac catheterization with angioplasty and stent placement to the right coronary artery, the patient returns to the ICU for overnight observation. Angioplasty is performed by a heart specialist (cardiologist) and a team of specialized cardiovascular nurses and technicians in a special operating room called a cardiac catheterization laboratory. http://www.merckmanuals.com/professional/cardiovascular-disorders/cardiovascular-tests-and-procedures/cardiac-catheterization. Do not copy or redistribute in any form! Is there a surgical a/v fistula on the left? Possible risks associated with cardiac cath include: Bleeding or bruising where the catheter is put into the body (the groin, arm, neck, or wrist) Pain where the catheter is put into the body; Blood clot or damage to the blood . Carrozza JP. A list of your medications (including over-the-counter drugs) and dosages. After Your Heart Catheterization with Transradial (Wrist) Approach: Self-care after your test. Pain, swelling, bleeding or discharge (yellow or green) from where the catheter went into your skin. Policy. Since then, however, I wage a constant battle to keep my dose stable and am always encountering foods or supplements that can send my PT/INR levels shooting up or down the scale. Yes. This procedure is commonly used to view blood flow through the heart. This is normal. All rights reserved. We searched MEDLINE and EMBASE. A plug is a material that works with your body's natural healing processes to form a clot in your artery. If you have painless cracking, this is not unusual. 2018; doi:10.1016/j.echo.2018.03.008. Your provider then injects contrast material through the catheter and creates X-ray movies (coronary angiogram or coronary angiography) as the contrast material moves through your hearts chambers, valves and major vessels. Your provider may do this as a scheduled procedure or shortly after a heart attack. Complex regional pain syndrome and acute carpal tunnel syndrome following radial artery cannulation: a neurological perspective and review of the literature. doi: 10.1002/ccd.28357. All rights reserved. This site needs JavaScript to work properly. One million cardiac catheterizations take place in the U.S. each year, but the chances of a major complication during a heart catheterization for diagnostic reasons is less than 1%. Leite JC, Jerosch-Herold C, Song F. A systematic review of the psychometric properties of the Boston Carpal Tunnel Questionnaire. One million cardiac catheterizations take place in the U.S. each year, but the chances of a major complication during a heart catheterization for diagnostic reasons is less than 1%. For some cases which are very short, you may not receive a sedative, especially if your provider wants to take certain kinds of measurements such as pressure inside your heart chambers. the unsubscribe link in the e-mail. You may shower 24 hours after the procedure. Rotablation, a special procedure to treat calcium deposits in arteries. Consultant and interventional cardiologist at Herzliya Medical Center. After Your Cardiac Catheterization. If your chest pain (angina) does not go away in 15 minutes after 3 sprays or pills of nitro, go to the nearest hospital emergency department or call 911. Confusing? Considering that the TRA is the predominant access site for cardiac catheterization procedures in many countries, there is little data around hand dysfunction post procedure.
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