Which option lists common acute complications of diagnostic coronary angiography?

• A. Coronary artery dissection, coronary spasm, arrhythmias, hematoma/bleeding at access site, air embolism
• B. Myocardial infarction due to plaque rupture
• C. Renal failure due to contrast administration
• D. Severe hypertension and edema

Answer: (A)

The main idea is identifying the immediate, catheter‑related risks that can arise during diagnostic coronary angiography. These are the events most likely to occur right around the procedure itself and are tied to accessing the arteries and manipulating catheters.

Coronary artery dissection can occur when the catheter or guide wire irritates or injures the intimal lining of a coronary artery, creating a tear that may reduce blood flow or require urgent management. Coronary spasm happens when the coronary arteries temporarily constrict in response to catheter and contrast exposure, producing chest pain and potential ischemia that usually responds to vasodilators like nitroglycerin. Arrhythmias can be triggered by catheter manipulation or transient ischemia, leading to premature beats, bradycardia, or other rhythm disturbances during engagement of the coronaries. Hematoma or bleeding at the access site is a direct consequence of puncturing an artery; it’s common to see a local groin or wrist bleed, hematoma, or even a pseudoaneurysm depending on the access site and technique. Air embolism, though rare, can occur if air is inadvertently introduced into the catheter system; it presents with sudden symptoms and requires prompt recognition and management.

The other options describe complications that are less characteristic of the diagnostic procedure itself. Myocardial infarction due to plaque rupture is a potential but not a common periprocedural event during diagnostic angiography; it’s more associated with acute plaque rupture in the coronary arteries or with interventions. Renal failure from contrast is a known risk, especially in patients with kidney disease, but it is more of a systemic adverse effect that isn’t as immediate or frequent as the local, catheter‑related issues listed above. Severe hypertension and edema are not typical acute complications of diagnostic angiography.