Nursing management of a patient with central retinal artery occlusion after percutaneous coronary intervention: a case report

Abstract

Background: Central retinal artery occlusion (CRAO) is a rare but critical complication that might appear after percutaneous coronary intervention (PCI) with a high risk of blindness. The report on the nursing management of CRAO patients after PCI is rare.

Case description: This patient is a 50-year-old female patient who was admitted to the Cardiovascular Department with repeated chest tightness. Initial assessment diagnosed as unstable angina and received a PCI. The patient complained of white patches in the left eye and blurred vision ten minutes after returning to the ward. The nurse found patient's symptoms at once and reported to the attending doctor for the first time of diagnosis. Fundus photography results confirmed the diagnosis of CRAO. The patient received high-flow oxygen inhalation and hyperbaric oxygen chamber treatment for days. Nitroglycerin sublingual administration and nitroglycerin intravenous micropump were used to improve retinal microcirculation. Finally, arterial thrombolysis was given to remove the embolism in the central retinal artery. The nurse played an important role in disease observation, risk identification, early detection, cooperation with doctors, post-thrombolytic care, and psychological care. The patient's left eye vision showed significant recovery, and she was discharged successfully. The patient reported gradual improvement in left-eye vision during the follow-up assessment.

Conclusions: This case report presents the interventions taken by nurses in early detection and care for a CRAO patient after PCI and expands the literature describing nursing management for patients with postoperative complications of PCI.

Keywords: Percutaneous coronary intervention (PCI); case report; central retinal artery occlusion (CRAO); ophthalmologic nursing; thromboembolism.

Figure 1

The result of fundus photography (cherry red spot).