Post-Angiography Care

Coronary angiography and PCI create two immediate clinical problems: an arterial puncture that must seal without impairing distal perfusion, and exposure to contrast and antithrombotic therapy that can uncover kidney injury or bleeding. The access site may be radial or femoral. Radial access is generally preferred for PCI because it lowers access-site bleeding and vascular complications, but it shifts surveillance toward the hand and forearm rather than eliminating risk. The first post-procedure question is not simply whether the dressing looks dry. Ask whether the patient is bleeding, becoming ischemic, developing recurrent cardiac symptoms, or losing effective circulating volume. A small radial-site bruise in a stable patient is very different from an expanding, tense forearm with pain on passive finger extension. Similarly, a femoral puncture site can appear quiet while a retroperitoneal hemorrhage is evolving internally. Canadian NP authority to order investigations, prescribe, and manage complications varies by province, employer, and privileges. Within that authority, use local cath-lab pathways while coordinating urgently with the interventional cardiology team for suspected major bleeding, acute limb ischemia, recurrent ischemia, or anaphylaxis.