Left Atrial Pressure

The pulmonary capillary wedge pressure or PCWP (also called the pulmonary wedge pressure or PWP, or pulmonary artery occlusion pressure or PAOP) or cross-sectional pressure, is the pressure measured by wedging a pulmonary catheter with an inflated balloon into a small pulmonary arterial branch.[1]

Physiologically, distinctions can be drawn among pulmonary venous pressure, pulmonary artery pressure, pulmonary capillary wedge pressure, and left atrial pressure, but not all of these can be measured in a clinical context.[2]

Noninvasive estimation techniques have been proposed.[3]

Clinical significance

Site Normal
pressure range
(in mmHg)[4]
Central venous pressure 3–8
Right ventricular pressure systolic 15–30
diastolic 3–8
Pulmonary artery pressure systolic 15–30
diastolic 4–12
Pulmonary vein/

Pulmonary capillary wedge pressure

2–15
Left ventricular pressure systolic 100–140
diastolic 3-12

Because of the large compliance of the pulmonary circulation, it provides an indirect measure of the left atrial pressure.[5]

For example, it is considered the gold standard for determining the cause of acute pulmonary edema; this is likely to be present at a PCWP of >20mmHg. It has also been used to diagnose severity of left ventricular failure and mitral stenosis,[6] given that elevated pulmonary capillary wedge pressure strongly suggests failure of left ventricular output.[7]

Pulmonary edema with normal PCWP suggest a diagnosis of acute respiratory distress syndrome (ARDS) or non cardiogenic pulmonary edema (as in opiate poisoning) .

Physiological pressure: 6–12 mm Hg.[8]

References

External links

  • GPnotebook
  • Overview at cvphysiology.com
  • Description at virginia.edu
  • Medical Subject Headings (MeSH)
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