Cardiac Catheterization: Right- and Left-Heart Catheterization
Myocardial performance is determined by the combined effects of preload, afterload, and contractility. In vivo myocardial performance is represented by the cardiac output, while loading conditions are defined by the interplay between volume, pressure, and vascular resistance within the cardiac chambers and great vessels. Clinical decision-making is often based on the best estimate of these central hemodynamic measures, in addition to the physical examination and a variety of biochemical and noninvasive tools. This approach is often successful; however, there are circumstances where clinical judgment or patient characteristics limit the utility of a noninvasive assessment. In these individuals, direct assessment of cardiovascular hemodynamics may provide the only route to a clear diagnosis or a thoughtful treatment plan.
In this chapter, the principles and practice of left- and right-heart catheterization as a method of invasive cardiovascular hemodynamic assessment will be discussed. In addition, the waveform characteristics of normal cardiovascular physiology will be reviewed as a prelude to the discussion of specific cardiovascular disease states presented in subsequent chapters.
KeywordsLeft-heart catheterization Right-heart catheterization Hemodynamics Artifacts Waveforms
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