A woman with severe mitral stenosis and mitral regurgitation has a pulmonary artery catheter inserted. The physician orders pulmonary artery pressure monitoring, including pulmonary capillary wedge pressures. The purpose of this is to help assess the:
A. Degree of coronary artery stenosis.
B. Peripheral arterial pressure.
C. Pressure from fluid within the left ventricle.
D. Oxygen and carbon dioxide concentration is the blood.
Correct Answer: C. Pressure from fluid within the left ventricle.
The pulmonary artery pressures are used to assess the heart’s ability to receive and pump blood. The pulmonary capillary wedge pressure reflects the left ventricle end-diastolic pressure and guides the physician in determining fluid management for the client. Pulmonary capillary wedge pressure (PCWP) is frequently used to assess left ventricular filling, represent left atrial pressure, and assess mitral valve function. It is measured by inserting a balloon-tipped, multi-lumen catheter (Swan-Ganz catheter) into a central vein, and advancing the catheter into a branch of the pulmonary artery.
Option A: The degree of coronary artery stenosis is assessed during a cardiac catheterization. Although it is used for cardiac hemodynamics and assessment of valvular lesions, its main diagnostic role is the assessment of coronary artery disease. In the contemporary era, left heart catheterization, especially selective coronary angiogram, is considered the gold standard test for coronary artery disease diagnosis.
Option B: The peripheral arterial pressure is assessed with an arterial line. Arterial pressure directly corresponds to cardiac output, arterial elasticity, and peripheral vascular resistance. Blood pressure is remarkably easy to alter and can be affected by many activities. In response to acute changes in blood pressure, the body responds through the baroreceptors located within blood vessels. Baroreceptors are a form of mechanoreceptor that becomes activated by the stretching of the vessel. This sensory information is conveyed to the central nervous system and used to influence peripheral vascular resistance and cardiac output.
Option D: An arterial blood gases (ABG) test measures the acidity (pH) and the levels of oxygen and carbon dioxide in the blood from an artery. This test is used to find out how well the lungs are able to move oxygen into the blood and remove carbon dioxide from the blood. As blood passes through the lungs, oxygen moves into the blood while carbon dioxide moves out of the blood into the lungs. An ABG test uses blood drawn from an artery, where the oxygen and carbon dioxide levels can be measured before they enter body tissues.
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