Clinically, the patient was diagnosed as having compartment syndrome of the right forearm with affection of the median nerve due to a postpunction haematoma following cardiac interventional therapy. However, the right radial artery pulse could be palpated without difficulty. The circumference of the right forearm was increased by 5 cm compared with the left. On examination, there was massive swelling of the forearm and blue-red discoloration. The pronator teres function was unremarkable. The motor function of the small thenar muscles and flexor pollicis longus, and flexor digitorum profundus of the index and middle fingers was slightly impaired. Neurological examination at this time revealed a sensory deficit of the right median nerve with decreased pinprick and light touch sensation as well as impaired two point discrimination. In addition, the patient noticed increasing swelling and subsequent hardening of the right forearm together with a blue-red discoloration.
One hour after treatment, the patient noticed diffuse pain in the right forearm as well as numbness in the thumb and index and middle fingers, with subsequent weakness of the thenar muscles and difficulty in flexion of the distal phalanges of the thumb and index finger. The patient received a combination of clopidogrel, acetylsalicylic acid, and intravenous heparin.
Catheterisation was performed via the right radial artery. A distal stenosis of the left anterior descending artery was dilated.
An 80% stenosis of the left anterior descending artery and a 90% stenosis of the posterior descending artery were stented. A 67 year old patient underwent interventional cardiac catheterisation for cardiac angina.
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