Hemodynamic Evaluation of Patients with Heart Failure

Abstract

In the proper setting, the use of a pulmonary artery catheter to measure hemodynamic parameters in the patient with chronic heart failure may be extremely helpful. During the management of the patient with chronic heart failure, it often becomes difficult to accurately define the patient’ s hemodynamic status by physical exam and chest radiograph alone. The radiographic appearance of pulmonary edema is neither sensitive nor specific for the diagnosis of pulmonary venous hypertension. In patients who have chronic elevations in the pulmonary capillary wedge pressure (PCWP), especially, compensatory mechanisms may make physical and radiographic exam findings unreliable (1–4). Invasive monitoring is particularly useful when the response to therapy is not adequate because it may help to better understand the underlying pathophysiology and, in turn, guide therapy.