Air Embolism: This is a common complication of angiographic procedures, including carotid angiograms. Air can enter the vascular system during the procedure, leading to embolism. Pleuritic chest pain can occur if the air embolus lodges in the pulmonary vasculature.

Pulmonary Embolism: Although less common than air embolism in this context, pulmonary embolism is a possible complication, especially if the patient has underlying risk factors for thromboembolism. The procedure itself can also increase the risk of thrombus formation.
Contrast-Induced Nephropathy with Pulmonary Edema: While not directly causing pleuritic chest pain, contrast-induced nephropathy can lead to pulmonary edema, which might present with chest pain. However, this would typically be associated with other symptoms like shortness of breath and signs of fluid overload.
Catheter-Related Complications: Including bleeding, hematoma, or pseudoaneurysm at the access site, which could indirectly cause chest pain if there's associated mediastinal or thoracic bleeding.

Aortic Dissection: Although rare, this is a potentially life-threatening condition that could occur as a complication of the angiogram, especially if the catheter caused trauma to the aortic wall. Pleuritic chest pain can be a presenting symptom, especially if the dissection involves the descending aorta.
Pneumothorax: This could occur due to accidental puncture of the lung during the procedure or as a complication of central line placement if attempted. It's crucial to diagnose promptly as it can quickly become life-threatening.

Vasovagal Reaction with Associated Cardiac Ischemia: A vasovagal reaction during the procedure could lead to bradycardia and hypotension, potentially causing cardiac ischemia, which might present with chest pain.
Thromboembolic Events from Catheter-Induced Thrombosis: While the catheter is in place, there's a risk of thrombus formation on the catheter, which could break loose and cause a thromboembolic event, including pulmonary embolism or systemic embolism if the procedure involves the left side of the heart.
Anaphylactoid Reaction to Contrast: A severe reaction to the contrast medium could present with a variety of symptoms, including chest pain, although this would typically be accompanied by other systemic symptoms like rash, hypotension, and respiratory distress.