Complications of Cardiac Investigation

There are many possible complications of cardiac catheterization and the studies associated with that procedure. These complications fall into three groups. There are those related simply to the passage of the catheter, those due to the injection of various substances as part of the pro-cedure, and those due to accidental introduction of other undesirable elements into the cardiovascu-lar system. Complications of premedication or of anmsthesia are omitted from this discussion. The incidence of the various complications varies greatly. Stimulation of ectopic beats by the impact of the catheter on the ventricular endocardium is a regular and anticipated feature of cardiac catheterization. On the other hand knotting of the catheter inside the heart is an extremely rare event. The occurrence of many of the complications is unpredictable but may be catastrophic. Their incidence may well be an inverse function of the experience and skill of the investigator but equally at times merely represents local misfortune. The frequency of serious complications can probably only be judged from published mortality rates. In 1953 a committee of the American Heart Association (Cournand et al., 1953) recorded four deaths following catheterization in approximately 5700 procedures performed in eight laboratories: there were no deaths with 1325 angiograms reported by that committee. A Swedish survey published in 1959 (Bagger et al., 1957)