Post Insertion Hematoma

Haematoma can cause extensive bruising

by Gemita - 2024-09-21 16:32:13

Haematoma, bruising, swelling, pain around the device pocket, or at catheter access sites are common following pacemaker implant. 

A haematoma is an abnormal collection of blood from leakage of a large blood vessel, artery or vein which has been damaged during the implant procedure causing blood to leak into tissues where it does not belong.  A haematoma usually resolves on its own but might need draining or treating depending on symptoms.  Bruising describes bleeding/leakage from trauma to smaller blood vessels, which usually don’t require any treatment.

If you have increased swelling or pain or the bruising seems to be getting more extensive, I would seek medical advice, although it seems you have already been back to your clinic.  Did they give you any advice?  Are you on any blood thinners because they can make the bleeding worse.

When they went through my femoral artery some years ago, the injury was traumatic and I suffered severe bruising for several weeks from the groin right down to below the knee.  I sought early medical help and they did an ultrasound and confirmed that I had a pseudo aneurysm.  I had to come off anticoagulation and remain in hospital for a few days and had another ultrasound to make sure that my injury had healed/sealed before hospital discharge and before I was able to take my anticoagulant.

Haematomas/bruising can look extensive and may take several weeks to completely fade/disperse.  And they can drain far before stopping.   Icing can help (wrap ice blocks in cloth before applying to skin.  I didn’t leave for longer than 5 mins at a time).  I was also told to elevate the affected limb..  Time 3-4 weeks should heal everything, but if you are concerned please seek advice.  Keep a close eye on the wound in case the haematoma causes an infection, or needs treating.  I would get plenty of rest while the haematoma is actively draining

Hematoma suggestion

by PSUCW2024 - 2024-09-22 12:26:33

Thanks for the suggestions as they did not give me much from my visit to the clinic. I saw the PA and she said I could apply pressure to the area if I felt it helped but said not to put ice directly on the area. 
Nothing further was explained other than it would likely be a month for the area to totally heal and if I notice it becoming worse contact them.

The bruising has moved now over my complete chest but is much darker around the pocket and on my left arm. I take Tylenol three times a day to help with the pain not sure how long I should continue with that. 

Pain Relief

by Gemita - 2024-09-22 13:48:08

As long as you don't need to increase the pain relief and you are not taking more than the recommended daily allowance of Tylenol, if it helps to bring some relief while you heal, I would continue on it, at least until your pain starts easing.

My bruising was horrendous too, various shades of deep purple as it slowly drained.  Fortunately I didn't have a pocket haematoma, only a haematoma/pseudo aneurysm at the catheter access sites.  A haematoma in the pocket needs watching for any signs of infection and these signs might include:  worsening swelling, worsening pain, worsening bleeding/bruising, discharge from the wound.  If these worsening signs occur, I would err on the side of caution and see a doctor immediately.  Infection if present, could quickly spread down the leads to the heart, so could potentially become serious if not treated early.

I suspect because of your valve repair you are on dual antiplatelet therapy (Clopidogrel/Aspirin) or other combination.  If so, they can be associated with an increased risk of haematoma, 

Hope you recover quickly, without intervention.