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What Causes Arm Pain And Painful Bumps On Hand After Removing Catheter?
Question: Hi there,
I had a coronary angiogram through the wrist five days ago. Two stents were fitted, and due to the position of the blockage, the procedure took a little longer than usual. (90 minutes)
I was kept in overnight and was released the next day. The doctor was pleased with the results and with my subsequent test results and I went home.
I've subsequently not suffered any fever or chest pain. My appetite has been good. However, two days after I arrived home my arm through which the catheter was passed, began hurting quite a lot. I have been taking painkillers, paracetamol and coding, and the pain seems to have gone now.
However, I have been left with some very very small and painful spot sized bumps on the palm of my right hand, and some even smaller ones on the palm of my left hand. They are hardly noticeable, but they are there.
I do have hayfever and asthma, and wonder if I need to just take some antihistamines, or if I should seek medical assistance immediately. Thanks.
I had a coronary angiogram through the wrist five days ago. Two stents were fitted, and due to the position of the blockage, the procedure took a little longer than usual. (90 minutes)
I was kept in overnight and was released the next day. The doctor was pleased with the results and with my subsequent test results and I went home.
I've subsequently not suffered any fever or chest pain. My appetite has been good. However, two days after I arrived home my arm through which the catheter was passed, began hurting quite a lot. I have been taking painkillers, paracetamol and coding, and the pain seems to have gone now.
However, I have been left with some very very small and painful spot sized bumps on the palm of my right hand, and some even smaller ones on the palm of my left hand. They are hardly noticeable, but they are there.
I do have hayfever and asthma, and wonder if I need to just take some antihistamines, or if I should seek medical assistance immediately. Thanks.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello XXXX!
Thank you for asking on HCM!
Regarding your concern, I would explain that coronary angioplasty by using transradial approach seems to have more advantage compared to transfemoral approach, facing much lower local puncture site complications. So, the risk of bleeding, hematoma, and other mechanical complications is quite low.
Nevertheless, in a quite small proportion of patients have occurred some rare complications like radial artery spasms with transient hand ischemia and pain, sometimes, radial artery thrombosis and occlusion which is a more serious event, but usually is successfully overcome. very rare happens radial artery dissection.
Returning to your concrete complains, I would explain that the arm pain you have experienced may be caused by local trauma during the procedure or a transient limb ischemia (probably artery spasms or a partial occlusion).
Regarding your skin symptomatology (those bilateral very small and painful spot sized bumps), I am afraid of and highly recommend to rule out first a cholesterol embolism phenomenon.
Sometimes, when manipulation inside aorta via procedural catheter, there exists the risk to disrupt any atherosclerotic plaque and to create cholesterol particles amenable to potentially embolize and jeopardize certain tissue areas, where they finally are trapped inside smaller vessels (leading to tissue ischemia and many times gangrene).
So the most probable option to rule out/in first is what is called livedo reticularis (cholesterol embolism).
I recommend you to consult your doctor immediately to perform this differential diagnosis.
Nevertheless, there is not place to be panic!
Just an appropriate diagnosis and follow up is necessary.
If you would upload a photo of those skin lesions, I could give my medical opinion.
Hope to have been helpful!
Feel free to ask me whenever you need. Greetings! Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello XXXX!
Thank you for asking on HCM!
Regarding your concern, I would explain that coronary angioplasty by using transradial approach seems to have more advantage compared to transfemoral approach, facing much lower local puncture site complications. So, the risk of bleeding, hematoma, and other mechanical complications is quite low.
Nevertheless, in a quite small proportion of patients have occurred some rare complications like radial artery spasms with transient hand ischemia and pain, sometimes, radial artery thrombosis and occlusion which is a more serious event, but usually is successfully overcome. very rare happens radial artery dissection.
Returning to your concrete complains, I would explain that the arm pain you have experienced may be caused by local trauma during the procedure or a transient limb ischemia (probably artery spasms or a partial occlusion).
Regarding your skin symptomatology (those bilateral very small and painful spot sized bumps), I am afraid of and highly recommend to rule out first a cholesterol embolism phenomenon.
Sometimes, when manipulation inside aorta via procedural catheter, there exists the risk to disrupt any atherosclerotic plaque and to create cholesterol particles amenable to potentially embolize and jeopardize certain tissue areas, where they finally are trapped inside smaller vessels (leading to tissue ischemia and many times gangrene).
So the most probable option to rule out/in first is what is called livedo reticularis (cholesterol embolism).
I recommend you to consult your doctor immediately to perform this differential diagnosis.
Nevertheless, there is not place to be panic!
Just an appropriate diagnosis and follow up is necessary.
If you would upload a photo of those skin lesions, I could give my medical opinion.
Hope to have been helpful!
Feel free to ask me whenever you need. Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doctor,
Many thanks for the email. I'm sorry but I made a mistake in my symptoms. I explained that the very small bumps on my hands were painful. They're actually not painful at all so I'm not sure why I mentioned that!
There are very tiny skin coloured bumps on the palm of my right hand near the wrist where the catheter was inserted, but there are some very minor bumps also on the left palm too. Again, none of these bumps hurt. And I can't see any more on any other part of my body including around the wrist where the catheter was inserted. Does this make a difference to your advice? Thanks.
Many thanks for the email. I'm sorry but I made a mistake in my symptoms. I explained that the very small bumps on my hands were painful. They're actually not painful at all so I'm not sure why I mentioned that!
There are very tiny skin coloured bumps on the palm of my right hand near the wrist where the catheter was inserted, but there are some very minor bumps also on the left palm too. Again, none of these bumps hurt. And I can't see any more on any other part of my body including around the wrist where the catheter was inserted. Does this make a difference to your advice? Thanks.
Brief Answer:
I still recommend you to consult your attending cardiologist.
Detailed Answer:
Hello again!
Coming to this point, the best thing to do is a physical inspection of those skin lesions.
Could you upload the imagines?
I still insist to discuss with your attending doctor for a differential diagnosis.
Wish you a good health! Dr. Iliri
I still recommend you to consult your attending cardiologist.
Detailed Answer:
Hello again!
Coming to this point, the best thing to do is a physical inspection of those skin lesions.
Could you upload the imagines?
I still insist to discuss with your attending doctor for a differential diagnosis.
Wish you a good health! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doctor,
In natural light, it's hardly noticable, so I took the photo in the worst light to show it up more. Please see attached. I looked up livedo reticularis and the skin of the sufferers seemed mottled which mine doesn't. I've attached the photo in any case. Thanks.
In natural light, it's hardly noticable, so I took the photo in the worst light to show it up more. Please see attached. I looked up livedo reticularis and the skin of the sufferers seemed mottled which mine doesn't. I've attached the photo in any case. Thanks.
Brief Answer:
No attachments found!
Detailed Answer:
Hi XXXX!
I can't see any attachment. Could you please try to upload again!
Whatever it be, seems to be some hardly noticeable skin alterations (as you have examined), thus meaning minor pathological changes. So, don't worry!
Regards! Dr. iliri
No attachments found!
Detailed Answer:
Hi XXXX!
I can't see any attachment. Could you please try to upload again!
Whatever it be, seems to be some hardly noticeable skin alterations (as you have examined), thus meaning minor pathological changes. So, don't worry!
Regards! Dr. iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Is it here now? Thanks.
Brief Answer:
A differential diagnosis should be done.
Detailed Answer:
Hi XXXX!
I reviewed your uploaded photo, and I thing that a differential diagnosis between vasculitis and livedo reticularis should be done, in addition of other alternative etiological factors. Probably you need to contact even a dermatologist for a careful live physical inspection of those lesions (they are not so minor as you said before).
Best wishes! Dr. Iliri!
A differential diagnosis should be done.
Detailed Answer:
Hi XXXX!
I reviewed your uploaded photo, and I thing that a differential diagnosis between vasculitis and livedo reticularis should be done, in addition of other alternative etiological factors. Probably you need to contact even a dermatologist for a careful live physical inspection of those lesions (they are not so minor as you said before).
Best wishes! Dr. Iliri!
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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