Differential Diagnosis for Arm Pain and Decreased Sensation Post-Angiogram and Cardiac Catheterization

Single Most Likely Diagnosis

• Hematoma or pseudoaneurysm at the access site: This is a common complication following angiogram and cardiac catheterization, especially if the patient has been on anticoagulation therapy. The pain and decreased sensation could be due to compression of the adjacent nerve or vascular structures by the hematoma.

Other Likely Diagnoses

• Vascular access site infection: Infection at the site of the catheter insertion can cause pain, swelling, and decreased sensation due to inflammation and potential nerve involvement.
• Nerve injury: Direct trauma to the nerves during the procedure can result in pain and sensory deficits.
• Thrombosis or embolism: Clot formation or embolism in the arm's blood vessels can lead to ischemia, causing pain and decreased sensation.

Do Not Miss Diagnoses

• Compartment syndrome: A serious condition that can occur if there is increased pressure within the muscle compartments of the arm, potentially leading to nerve and muscle damage. It is crucial to identify and treat promptly to avoid long-term damage.
• Arterial dissection or rupture: Although less common, these are potentially life-threatening conditions that require immediate medical attention.

Rare Diagnoses

• Complex regional pain syndrome (CRPS): A rare condition characterized by chronic pain, inflammation, and hypersensitivity following trauma or injury, which could be related to the catheterization procedure.
• Neuropraxia or neuropathy: Direct injury to the nerves or ischemia can cause neuropraxia (temporary nerve dysfunction) or neuropathy, leading to pain and sensory changes.