Pulmonary Capillary Wedge
Also written as PCWP.
A pulmonary artery catheter is inserted, and the pulmonary capillary wedge pressure (PCWP) is measured at 12 mmHg.
What our notes say
- A pulmonary artery catheter is inserted, and the pulmonary capillary wedge pressure (PCWP) is measured at 12 mmHg. (Pulmonary oedema and ARDS)
- Pulmonary crackles (crepitations): Bibasilar, fine, end-inspiratory crackles caused by transudative alveolar fluid secondary to raised pulmonary capillary wedge pressure. (Cardiomyopathies)
- the patient has an inferior vena cava filter in place or when mitral stenosis is present, there is a diastolic presrequires prolonged hemodynamic monitoring. sure gradient between the pulmonary capillary wedge (Harrisons Cardiovascular Medicine 2nd Edition 2)
- Pulmonary Capillary Wedge Pressure (PCWP): Elevated PCWP (>18 mmHg) suggests cardiogenic pulmonary oedema. (Pulmonary oedema and ARDS)
- Right heart catheterisation shows a mean pulmonary artery pressure (mPAP) of 55 mmHg and a pulmonary capillary wedge pressure (PCWP) of 10 mmHg. (Pulmonary hypertension and cor pulmonale)
- Vasodilators: If systolic blood pressure remains adequate, start an intravenous nitrate infusion (glyceryl trinitrate) to unload the left ventricle by reducing systemic vascular resistance and pulmonary capillary wedge pressure. (Cardiomyopathies)
Study material on Pulmonary Capillary Wedge
- Harrisons Pulmonary and Critical Care Medicine
- Harrisons Cardiovascular Medicine 2nd Edition 2
- Pulmonary oedema and ARDS
- Pulmonary hypertension and cor pulmonale
Practice questions on Pulmonary Capillary Wedge
A 32-year-old woman with no cardiopulmonary disease has progressive exertional dyspnea, syncope on exertion, and loud P2 on auscultation. Right heart catheterization shows mean pulmonary artery pressure of 38 mmHg with normal pulmonary capillary wedge pressure. Most likely diagnosis?
- Pulmonary arterial hypertension (PAH)
- Left ventricular failure
- Pulmonary embolism
- Mitral stenosis
Answer: A. Progressive exertional dyspnea, syncope on exertion, and a loud P2 are suggestive of pulmonary hypertension. The right heart catheterization findings of elevated mean pulmonary artery pressure (38 mmHg) with a normal pulmonary capillary wedge pressure (indicating no left heart failure) confirm pre-capillary pulmonary hypertension, most consistent with Pulmonary Arterial Hypertension (PAH).