RELATIVE CONTRAINDICATIONS TO DIAGNOSTIC CARDIAC CATHETERIZATION
RELATIVE CONTRAINDICATIONS TO DIAGNOSTIC CARDIAC CATHETERIZATION
1. Uncontrolled ventricular irritability: the risk for ventricular
tachycardia/fibrillation during catheterization is increased if
ventricular irritability is uncontrolled
2. Uncorrected hypokalemia or digitalis toxicity
3. Uncorrected hypertension: predisposes to myocardial
ischemia and/or heart failure during angiography
4. Intercurrent febrile illness
5. Decompensated heart failure, especially acute pulmonary
edema
6. Anticoagulation state; international normalized ratio (INR) >1.8, femoral approach
7. Severe allergy to radiographic contrast agent
8. Severe renal insufficiency and/or anuria, unless dialysis is
planned to remove fluid and radiographic contrast load
PATIENT FOR CATHETERIZATION
Age
• Infant: < 1 y old
• Elderly: > 70 y old
Functional class
• Mortality ↑ 10-fold for class IV patients compared with I
and II
Severity of coronary obstruction
• Mortality ↑ 10-fold for left main disease compared with
one- or two-vessel disease
Valvular heart disease as an independent lesion
• Greater risk when associated with coronary artery disease
Left ventricular dysfunction
• Mortality ↑ 10-fold in patients with low ejection fraction
(< 30%)
Severe noncardiac disease
Renal insufficiency
Insulin-requiring diabetes
Advanced peripheral and cerebral vascular disease
Severe pulmonary insufficiency
