Learning Objectives

Identify the normal pressure ranges within the four cardiac chambers and great vessels. Understand the clinical significance of Pulmonary Capillary Wedge Pressure (PCWP). Distinguish between PCWP and Left Ventricular End-Diastolic Pressure (LVEDP) in valvular disease. Recognize the Swan-Ganz catheter as the gold standard for invasive hemodynamic monitoring.

Hemodynamic Pressure Monitoring

Normal resting cardiac pressures are essential for diagnosing heart failure, pulmonary hypertension, and valvular pathology.

• Pulmonary Capillary Wedge Pressure (PCWP):
  Measured in mmHg, this is a good approximation of left atrial pressure.
• Measurement Technique:
  PCWP is measured using a pulmonary artery catheter, commonly known as a Swan-Ganz catheter.
• Clinical Correlation:
  Under normal conditions, PCWP mirrors the Left Ventricular End-Diastolic Pressure (LVEDP).

Key Diagnostic Exception: Mitral Stenosis

While PCWP usually reflects LV pressure, certain pathologies disrupt this relationship:

• Mitral Stenosis: In this condition, PCWP > LV end-diastolic pressure.
• Reasoning: The stenotic valve creates a pressure gradient, meaning the pressure in the left atrium (and thus the PCWP) must stay elevated to push blood into the ventricle.

Normal Pressure Reference Table

Activity