Cardiovascular disease remains one of the leading causes of death worldwide, and in Australia, it accounts for more than a quarter of all deaths. On average, 118 Australians die from heart disease every day. That’s one person every 12 minutes. Cardiac catheterisation is a common procedure used to diagnose and treat heart conditions. It has become safer and more effective over the years, but like any invasive procedure, careful monitoring and nursing care afterwards is essential to prevent complications.

Cardiac catheterisation involves inserting a thin, flexible tube (catheter) into a blood vessel, usually in the groin, wrist, or neck, and guiding it into the heart. Depending on the reason for the procedure, it may be:

• Diagnostic: to measure pressures inside the heart, check blood flow, or look for blockages.
• Interventional: where the catheter is used as an alternative to open-heart surgery. This can include procedures such as placing a stent, widening a narrowed artery, or closing a defect in the heart wall.
• Most procedures are performed under local anaesthetic with sedation, rather than a full general anaesthetic.
• Although the risk of major complications is low – less than 1% for diagnostic procedures – issues can still arise. Age, existing health conditions, the complexity of the procedure, and the access site all affect risk. Nurses and healthcare professionals play a vital role in spotting problems early and providing prompt care, which can significantly improve outcomes.

Good post procedure care starts with a thorough understanding of the patient’s background and the procedure itself. Key points to consider include:

• Was the catheter diagnostic or interventional? Interventional procedures usually carry higher risk.
• Did the patient take anticoagulant or blood-thinning medication beforehand? This increases bleeding risk.
• What was the patient’s normal heart rhythm before the procedure?
• Where was the catheter inserted, and was it placed in an artery or a vein?
• Are there factors like advanced age or other health conditions that increase risk?

Physical assessment is just as important. The puncture site should be checked regularly for bleeding, swelling, infection, or bruising. Circulation and sensation in the affected limb should also be monitored closely. Here are some of the complications that can arise:

• Bleeding and Haematoma: Bleeding from the puncture site is the most common complication. Nurses should watch carefully during activities like coughing or vomiting, which can trigger bleeding. If bleeding occurs, apply firm pressure with gauze for 5–10 minutes, reinforce dressings, and notify a doctor.
• Arrhythmias: Abnormal heart rhythms can sometimes occur after the procedure. Continuous cardiac monitoring helps detect changes quickly. If the arrhythmia is new or causing reduced cardiac output, urgent medical review is needed.
• Pseudoaneurysm: A pseudoaneurysm may develop if blood leaks into surrounding tissue and creates a pulsating mass near the puncture site. Small pseudoaneurysms may resolve on their own, but larger ones may need ultrasound-guided treatment or surgery.
• Allergic Reactions: Some patients react to contrast dye, local anaesthetics, or medications used during the procedure. Mild reactions may cause rashes or nausea, while severe cases can resemble anaphylaxis and require immediate treatment with IV adrenaline, corticosteroids and antihistamines.

Nurses are often the first to notice subtle changes in a patient’s condition. Their role in monitoring vital signs, observing the puncture site, and supporting patients through recovery is critical. Early recognition of complications can be life-saving.

After cardiac catheterisation, patients are usually observed in a recovery area before returning to their ward or being discharged. Key aspects of care include:

• Bed rest: Patients are typically kept lying flat for several hours, around four hours after diagnostic procedures and six hours after interventional ones. This reduces the risk of bleeding from the puncture site.
• Positioning: The patient can shift gently side to side for comfort, but the head of the bed should stay below 30 degrees until bed rest is complete.
• First mobilisation: Nurses should assist patients when they first get up, checking blood pressure while lying, sitting, and standing to reduce the risk of dizziness or fainting.
• Pain management: Discomfort at the puncture site or from lying still for long periods can be managed with simple pain relief.
• Hydration and diet: Patients are encouraged to drink fluids to help flush the contrast dye from their system. Most can eat and drink soon after the procedure, unless otherwise directed by the doctor.

For patients who have had a straightforward diagnostic procedure, same-day discharge is often possible. Those undergoing interventions such as stent placement are usually kept overnight for closer monitoring.

Cardiac catheterisation is now one of the most common and effective procedures for diagnosing and treating heart disease. While the risk of complications is low, the period immediately after the procedure is vital for patient safety. Careful monitoring, early detection of complications, and supportive nursing care ensure the best possible outcomes.

With heart disease continuing to be one of Australia’s biggest health challenges, the role of healthcare professionals in post-catheterisation care has never been more important.