Pulmonary capillary wedge pressure

Pulmonary Capillary Wedge Pressure
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Pulmonary Capillary Wedge Pressure (PCWP) is a hemodynamic measurement used to assess the left atrial pressure in the heart. It is an important parameter in the evaluation of patients with heart failure, pulmonary hypertension, and other cardiovascular conditions.

Physiology

The pulmonary capillary wedge pressure is an indirect measure of the left atrial pressure. It is obtained by inserting a Swan-Ganz catheter into a peripheral vein, advancing it through the right side of the heart, and "wedging" it in a small pulmonary artery. When the balloon at the tip of the catheter is inflated, it occludes the artery, and the pressure measured at the tip reflects the pressure in the left atrium.

Measurement Technique

The measurement of PCWP is performed using a pulmonary artery catheter, also known as a Swan-Ganz catheter. The procedure involves the following steps:

1. Insertion of the catheter into a large vein, typically the internal jugular vein or subclavian vein.
2. Advancement of the catheter through the right atrium, right ventricle, and into the pulmonary artery.
3. Inflation of the balloon at the catheter tip to occlude a branch of the pulmonary artery.
4. Measurement of the pressure at the catheter tip, which reflects the left atrial pressure.

Clinical Significance

PCWP is a critical measurement in the management of patients with various cardiovascular conditions. It provides valuable information about the left ventricular filling pressure and can help guide treatment decisions.

Heart Failure

In patients with heart failure, PCWP is used to assess the degree of congestion and guide therapy. Elevated PCWP indicates increased left atrial pressure and pulmonary congestion, which may require diuretics or other interventions.

Pulmonary Hypertension

PCWP is also used to differentiate between different types of pulmonary hypertension. A normal PCWP suggests pulmonary arterial hypertension, while an elevated PCWP indicates pulmonary venous hypertension due to left heart disease.

Acute Respiratory Distress Syndrome

In acute respiratory distress syndrome (ARDS), PCWP can help differentiate between cardiogenic and non-cardiogenic pulmonary edema. A normal PCWP in the presence of pulmonary edema suggests a non-cardiogenic cause.

Interpretation

The normal range for PCWP is typically 6-12 mmHg. Values above this range suggest increased left atrial pressure and potential left heart dysfunction. Interpretation of PCWP should be done in conjunction with other hemodynamic parameters and clinical findings.

Complications

The procedure to measure PCWP is generally safe but can have complications, including:

• Pulmonary artery rupture
• Infection
• Arrhythmias
• Thrombosis

Conclusion

Pulmonary capillary wedge pressure is a valuable tool in the assessment of cardiac function and the management of various cardiovascular conditions. It provides insight into left atrial pressure and helps guide therapeutic decisions.

Cardiovascular disease A-Z

Most common cardiac diseases

• Cardiac arrhythmia‎
• Cardiogenetic disorders‎
• Cardiomegaly‎
• Cardiomyopathy‎
• Cardiopulmonary resuscitation‎
• Chronic rheumatic heart diseases‎
• Congenital heart defects‎
• Heart neoplasia‎
• Ischemic heart diseases‎
• Pericardial disorders
• Syndromes affecting the heart‎
• Valvular heart disease‎

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

A

• Accelerated idioventricular rhythm
• Acute decompensated heart failure
• Arteriosclerotic heart disease
• Athletic heart syndrome
• Atrial flutter
• Atrioventricular fistula
• Cardiovascular disease in Australia
• Autoimmune heart disease

B

• Brown atrophy of the heart

C

• Ebb Cade
• Cardiac allograft vasculopathy
• Cardiac amyloidosis
• Cardiac asthma
• Cardiac tamponade
• Cardiogenic shock
• Cardiogeriatrics
• Cardiorenal syndrome
• Cardiotoxicity
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• Spontaneous coronary artery dissection
• Coronary artery ectasia
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• Coronary vasospasm
• Cœur en sabot
• Coxsackievirus-induced cardiomyopathy

D

• Duke Treadmill Score
• Duroziez's disease

E

• Eisenmenger's syndrome
• Embryocardia
• Endocardial fibroelastosis
• Eosinophilic myocarditis

H

• Heart attack
• Heart failure
• Heart failure with preserved ejection fraction
• Heart to Heart (1949 film)
• High-output heart failure
• Hyperdynamic precordium

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

I

• Idiopathic giant-cell myocarditis
• Interventricular dyssynchrony
• Intraventricular dyssynchrony
• Isolated atrial amyloidosis

K

• Keshan disease

L

• Loeffler endocarditis

M

• Mydicar
• Myocardial bridge
• Myocardial disarray
• Myocardial rupture
• Myocardial scarring
• Myocardial stunning
• Myocarditis

N

• Nonbacterial thrombotic endocarditis

O

• OLR1
• Ostial disease

P

• Papillary fibroelastoma
• Pathophysiology of heart failure
• Postpericardiotomy syndrome
• Pulmonary vein stenosis

R

• Right axis deviation
• Roemheld syndrome

S

• Saturated fat and cardiovascular disease
• SCAR-Fc
• Shone's syndrome
• Strain pattern
• Subacute bacterial endocarditis
• Sudden cardiac death of athletes

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

T

• Traumatic cardiac arrest

V

• Ventricular aneurysm
• Vibroacoustic disease
• Viral cardiomyopathy

W

• Waon therapy