A 30 year old male was brought to the ER after a car crash. On admission, pulse is weak with BP=80/60 mmHg. ECG is shown below. Right hea catheter is placed. Which is the most consistent value with patient's diagnosis?
The ECG shows HR of 125bpm with variation in amplitude of QRS. This occurs when there is large amount of fluid in pericardial sac, which in the setting of trauma is patient's own blood. The ECG and clinical history points to diagnosis of Cardiac Tamponade. It is characterised by diastolic collapse of ventricles. Hence the PCWP will be equal to pulmonary aery diastolic pressure. This in turn will be equal to right atrial pressure.
RA pressure Pulmonary aery pressure PCWP 16 75/30 11
RA pressure Pulmonary aery pressure PCWP 16 34/16 16
RA pressure Pulmonary aery pressure PCWP 16 100/30 28
RA pressure Pulmonary aery pressure PCWP 16 45/22 20
Disease of pericardium