Wedge pressure

Wedge Pressure

Wedge pressure, also known as pulmonary capillary wedge pressure (PCWP), is a measurement used in medicine to estimate the pressure in the left atrium of the heart. This measurement is crucial in diagnosing and managing various cardiovascular diseases and conditions.

Overview

The wedge pressure is obtained during a right heart catheterization, where a catheter is threaded through the veins and into the right side of the heart. The catheter is then advanced into the pulmonary artery and a small balloon at the tip is inflated, causing the catheter to "wedge" in a small pulmonary arterial branch. The pressure measured at this point is the wedge pressure.

Clinical Significance

The wedge pressure is an important diagnostic tool in the evaluation of patients with suspected heart failure. It can help differentiate between heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF).

In pulmonary hypertension, the wedge pressure can help distinguish between pre-capillary and post-capillary causes. A high wedge pressure suggests a post-capillary cause, such as left heart disease, while a low wedge pressure suggests a pre-capillary cause, such as lung disease or chronic thromboembolic disease.

Limitations

While the wedge pressure is a valuable tool, it has limitations. It is an invasive procedure with potential complications, including infection, bleeding, and arrhythmias. Furthermore, the wedge pressure is a static measurement and does not provide information about dynamic changes in left atrial pressure.

See Also

• Right heart catheterization
• Heart failure
• Pulmonary hypertension