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Related Concept Videos

Vascular Spasm01:16

Vascular Spasm

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The vascular phase, also known as vasospasm, is the initial stage of hemostasis, crucial for preventing excessive bleeding when a blood vessel is injured. After a vessel is cut, nerves in the damaged area trigger pain and other sensory impulses. Simultaneously, the smooth muscles in the vessel wall contract, resulting in a vascular spasm. This contraction reduces the vessel's diameter at the injury site, slowing or stopping blood loss through the vessel wall. Vascular spasms typically last...
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Cardiac Catheterization IV: Nursing Management01:26

Cardiac Catheterization IV: Nursing Management

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Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
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Assessment of the Cardiovascular System III: Palpation01:27

Assessment of the Cardiovascular System III: Palpation

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Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
442
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
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ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

129
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

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Axillary Vein Spasm During Permanent Pacemaker Implantation.

Dinkar Bhasin1, Ankita Dhir, Yash Paul Sharma

  • 1Assistant Professor, Department of Cardiology, Postgraduate Institute of Medical Education and Research, Chandigarh-160012 India. dinkarbhasin@gmail.com.

The Journal of Invasive Cardiology
|November 1, 2022
PubMed
Summary

Axillary vein spasm management requires avoiding repeat punctures. Infuse fluids and nitroglycerin ipsilaterally, wait before re-attempting, and consider alternative sites if spasm persists.

Keywords:
axillary vein spasmpermanent pacemaker implantationvenogram

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Area of Science:

  • Vascular Access Management
  • Interventional Cardiology

Background:

  • Axillary vein spasm presents a significant challenge during central venous access procedures.
  • Improper management can lead to procedural complications and patient discomfort.

Purpose of the Study:

  • To illustrate effective strategies for managing axillary vein spasm.
  • To provide guidance on optimizing venous access in the presence of spasm.

Main Methods:

  • Case example detailing the diagnosis and management of axillary vein spasm.
  • Utilized ipsilateral intravenous fluids and nitroglycerin for spasm relief.
  • Incorporated repeat venography to assess spasm resolution.
  • Described alternative puncture sites and contralateral access for refractory cases.

Main Results:

  • Avoiding repeated puncture attempts is crucial to prevent worsening spasm.
  • Ipsilateral nitroglycerin administration effectively relieved spasm in incremental doses.
  • Repeat venography confirmed spasm resolution, guiding successful puncture.
  • Medial axillary vein or subclavian vein access served as effective alternatives.

Conclusions:

  • A structured approach involving fluid/nitroglycerin administration and delayed re-puncture is effective for axillary vein spasm.
  • Contralateral access is a viable option for refractory cases.
  • Proper management of axillary vein spasm ensures procedural success and patient safety.