- Access: Radial artery preferred (↓ bleeding complications vs. femoral).
- PCI Goal: STEMI door-to-balloon time <90 min.
- Hemodynamics:
- PCWP (Wedge pressure) ≈ Left Atrial Pressure.
- Tamponade: Equalization of diastolic pressures across all chambers.
- Key Complications:
- Retroperitoneal Hemorrhage: Sudden hypotension + back/flank pain (femoral access). Dx: CT Abd/Pelvis (non-contrast).
- Pseudoaneurysm: Pulsatile mass + systolic bruit.
- AV Fistula: No mass + continuous bruit/thrill.
- Cholesterol Embolization: “Blue toe,” livedo reticularis, eosinophilia, AKI.
- Contrast Nephropathy: Prevent with aggressive IV hydration.