Differential Diagnosis for Severe Back Pain after Left Heart Cath

• Single most likely diagnosis
  • Hematoma at the catheter site: This is a common complication of catheterization procedures, especially if the patient has been on anticoagulation therapy. The hematoma can cause pressure on the surrounding structures, leading to back pain.
• Other Likely diagnoses
  • Pseudoaneurysm formation: A pseudoaneurysm is a potential complication of arterial puncture, which can cause back pain due to the expanding mass effect.
  • Retroperitoneal hemorrhage: Although less common, a retroperitoneal hemorrhage can occur after a catheterization procedure, especially if there is a bleeding complication. This can cause severe back pain.
  • Musculoskeletal strain: The procedure may cause strain on the back muscles, leading to pain.
• Do Not Miss diagnoses
  • Aortic dissection: Although rare, an aortic dissection is a life-threatening condition that can cause severe back pain. It is a potential complication of catheterization procedures, especially if the catheter causes a tear in the aortic wall.
  • Spinal epidural hematoma: A spinal epidural hematoma is a rare but potentially devastating complication that can cause back pain, neurological deficits, and even paralysis.
• Rare diagnoses
  • Cholesterol embolization syndrome: This is a rare condition that can occur after a catheterization procedure, where cholesterol crystals are dislodged and embolize to other parts of the body, causing inflammation and pain.
  • Infection or abscess at the catheter site: Although rare, an infection or abscess at the catheter site can cause back pain, especially if it spreads to the surrounding tissues.