A 48 year old male is admitted to the interventional holding area after having a cardiac cath. The patient received a cardiac stent in the right coronary artery (RCA) and the insertion site was angiosealed. The insertion site is soft, no bruising noted, or active bleeding. Pulses are palpable in bilateral lower extremities. A sandbag in on the site which has to stay for another 1.5 hours per md orders. The patient is complaining of discomfort in the groin area and rates his pain 8 on 1-10 scale. In addition, the patient and his wife have verbalized they desire (but feel they will not be able to) to manage the new medication regime and post-op care and are having difficulty understanding why it is so important to take these new medications and quit smoking since he already “has his problem fixed with the stent placement”. He states he is going to have problems integrating these new “rules” into his daily life because he works around people who smoke all the time and does not want these medications to interfere with his life.interventional holding area after having a cardiac cath. The patient received a cardiac stent in the right coronary artery (RCA) and the insertion site was angiosealed. The insertion site is soft, no bruising noted, or active bleeding. Pulses are palpable in bilateral lower extremities. A sandbag in on the site which has to stay for another 1.5 hours per md orders. The patient is complaining of discomfort in the groin area and rates his pain 8 on 1-10 scale. In addition, the patient and his wife have verbalized they desire (but feel they will not be able to) to manage the new medication regime and post-op care and are having difficulty understanding why it is so important to take these new medications and quit smoking since he already “has his problem fixed with the stent placement”. He states he is going to have problems integrating these new “rules” into his daily life because he works around people who smoke all the time and does not want these medications to interfere with his life

Coronary artery stent placement like in the right coronary artery (RCA) involves the insertion of a flexible thin catheter through insertion points either in the wrist, arm, or groin.

In the above case, the patient has had an occlusion of the RCA for which stenting has been done through groin insertion. Upon re-examination of the insertion site, it looks normal without any bruising or active bleeding.

The groin pain the patient is having will subside within a few days until the insertion site has healed completely. Keeping the sandbag as advised on the insertion site will help reduce the pain.

The patient is advised with a new medication regimen along with advice to stop smoking, which he feels is quite tough to follow. He says he works along with people who are smokers. This leads to passive smoking effects. Passive smoking is one of the potential causes of coronary artery occlusions leading to fatal heart diseases.

Moreover, once stenting of an artery is done, care needs to be taken to maintain the health of the stented artery as well as the other arteries, so antiplatelet medications like clopidogrel, aspirin etc to maintain normal blood flow.

Hence, even if the stenting has been done, the patient should take the new medications and should restrain from both active and passive smoking to reduce his cardiac risks .