What diagnoses can the catheter help make?

What diagnoses can the catheter help make?_18.jpg

In addition to its use in the management of patients, the catheter can be useful in making some difficult diagnoses at the bedside. Constrictive pericarditis and pericardial tamponade have distinctive pressure waveforms detectable with the catheter. An acute ventricular septal defect resulting from myocardial infarction can be diagnosed by finding an increase in oxygen saturation between samples drawn from the proximal and distal ports. Another complication of acute myocardial infarction, right ventricular infarction, shows a typical “dip-and-plateau” pattern in the right ventricular pressure tracing. Atrial flutter may be diagnosed from a right atrial pressure tracing showing a waves occurring at a rate of 300/minute. Ventricular tachycardia may be diagnosed by dissociation of the a and v waves in a patient with wide complex tachycardia.

What complications are associated with use of a Swan-Ganz catheter?

All the complications of central venous cannulation

Risk of infection (increases the longer the catheter remains in place)

Right bundle branch block (especially in patients with preexisting left bundle branch block)

Ventricular tachyarrhythmias

Pulmonary infarction (if the tip migrates into a permanently wedged position)

Pulmonary rupture (if the balloon is overinflated)

Catheter knotting (from careless insertion)

What diagnoses can the catheter help make?_18.jpg

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