Pulmonary capillary wedge pressure -PCWP is measured by inserting balloon-tipped, multi-lumen catheter (Swan-Ganz catheter) into a peripheral vein, then advancing the catheter into the right atrium, right ventricle, pulmonary artery, and then into a branch of the pulmonary artery.
Swan-Ganz catheter | The pulmonary artery catheter (PAC) is frequently referred to as a Swan-Ganz catheter. PAC is the insertion of a catheter into a pulmonary artery. Its purpose is diagnostic; it is used to detect heart failure or sepsis, monitor therapy, and evaluate the effects of drugs. The pulmonary artery catheter allows direct, simultaneous measurement of pressures in the right atrium, right ventricle, pulmonary artery, and the filling pressure ("wedge" pressure) of the left atrium.
Acute Decompensated Heart Failure::: dyspnea, JVD, bilateral lung crackles + LE edema... the sudden increase in pulmonary capillary wedge pressure leads to accumulation of fluid in pulmonary interstitial; and alveolar spaces... the goal in patients without hypotension = REDUCE PRELOAD (diuretics and vasodilators like nitroglycerine or nitroprusside)