The introduction of the flow-directed pulmonary artery catheter (PAC)
by Swan and associates in 19701 made it possible
to perform right heart catheterization (RHC) at the bedside.
Right heart catheterization permits measurement of pulmonary artery
and right heart pressures and cardiac output. In addition, measurement of
pulmonary capillary or "wedge" pressure provides a close approximation of
left ventricular filling pressure.2 These measurements
are more accurate in determining a patient's hemodynamic status than estimates
based on clinical assessment.3 It was quickly
established that the PAC could be used to diagnose accurately the major complications
of acute myocardial infarction (AMI), such as left ventricular failure, cardiogenic
shock, ventricular septal defect, and mitral regurgitation.4
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