Alternative Names right heart catheterisation, catheterisation, right heart
Definition During the Swan-Ganz catheterisation, a thin flexible tube is inserted into the right side of the heart to measure and monitor its functions.
The test is usually done in severely ill, hospitalised persons to evaluate how the heart is functioning. It can determine the amount of blood flowing through the heart. It can also be used to monitor the effects of a heart attack, shock, and the effects of cardiovascular drugs.
How is the test performed? Swan-Ganz catheterisation is done in the hospital. First, the patient is given a mild sedative to help him or her relax. Then, an intravenous line is inserted into a vein in the arm to allow drugs to be delivered during the procedure. The procedure itself involves inserting a thin flexible tube, or catheter, into a large vein in the neck, groin, or arm. This catheter is then threaded all the way into the right side of the heart.
To begin, an area of skin on the neck, groin, or arm is cleaned with an antiseptic. A local anaesthetic is injected at the site to numb the area. A specialist, such as a cardiologist, makes a small incision at this site. Then, the Swan-Ganz catheter is inserted and threaded to the heart.
Once in the heart, the catheter is passed through the right atrium and the right ventricle. From there it goes into the pulmonary artery. All of this is sometimes guided by X-ray images. Heart function during the procedure is monitored by electrocardiography (ECG), a recording of the electrical activity of the heart.
What is involved in preparation for the test? A person will receive specific instructions from his or her doctor. Often, a Swan-Ganz catheter is placed during emergency situations, such as after a heart attack, when there is little time to prepare.
What do the test results mean? Normal values for various heart functions are as follows:
pulmonary artery systolic pressure, 15 to 30 mm Hg (millimetres of mercury)
pulmonary artery average pressure, 9 to 17 mm Hg
pulmonary diastolic pressure, 5 to 10 mm Hg
pulmonary capillary wedge pressure, 5 to 15 mm Hg
cardiac index, 2.4 to 3.8 litres per minute per square metre of body surface area
right atrial pressure, 0 to 5 mm Hg
Abnormal test results may indicate heart disease, shock, heart valve disease, or lung disease.
Author: David T. Moran, MD Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 6/06/2005 Contributors Potential conflict of interest information for reviewers available on request
