Dear Nurses

Wednesday, March 11, 2020


Scenario: Tom is a 45 year-old male who has a longstanding cardiac history. He is now in the ICU for complaints of shortness of breath on exertion, chest pain, and dizziness. A diagnosis of cardiomyopathy was made. The doctor discusses with Tom the need to do invasive heart monitoring.

How is invasive heart monitoring achieved?
Invasive heart monitoring can be accomplished through a pulmonary artery (PA) catheter, also known as the Swan-Ganz catheter.  The PA catheter is inserted by the doctor. The balloon near the tip is inflated as the catheter is advanced through the right heart chambers and into the pulmonary artery.

Scenario 2: Tom is placed in Trendelenburg position to make insertion of the PA catheter easy. Sterile gloves and equipment is used to accomplish this.

What can be determined from the tracings from inserting a  PA catheter?
The tracings shown in the image above are examples of what you would expect to see as the PA catheter is inserted. As the catheter is advanced through the heart chambers and even when in place,   the CVP (right atrium) pressure, right ventricle pressure, pulmonary artery pressure, and pulmonary artery wedge pressure (PCWP) can be read.


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