Swan-Ganz catheter

Case contributed by Reabal Najjar

Presentation

Mobile radiograph to assess endotracheal and nasogastric tube placement.

Patient Data

Age: 20
Gender: Female

Mobile chest radiograph

x_ray

The endotracheal tube tip is approximately 47mm above the carina. The nasogastric tube tip is not visualized however projects below the diaphragm. Interval insertion of a Swan-Ganz catheter. There is a right-sided PICC line, with its tip projecting over the superior right atrium. There is convexity at the pulmonary artery, in keeping with the known history of pulmonary arterial hypertension. Interval development of bilateral patchy consolidation in the mid to lower zones, worse on the right side. No large pleural effusion. No supine pneumothorax.

Case Discussion

This case demonstrates the position of a Swan-Ganz catheter in a patient with a background of pulmonary arterial hypertension. Swan-Ganz catheters (or pulmonary artery catheters) are typically inserted, ideally in the proximal right or left main pulmonary artery, to measure pulmonary arterial and capillary wedge pressures.

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