The Pulmonary Artery Catheter—Friend, Foe, or Accomplice?

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Abstract
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