In cases of right heart failure, what changes would you expect to see on a PA catheter?

In cases of right heart failure, an increase in central venous pressure (CVP) is observed due to the impaired ability of the right ventricle to effectively pump blood into the pulmonary circulation. This leads to a backlog of blood in the venous system and an increase in pressures within the great veins and right heart chambers.

Central venous pressure is a reflection of the right atrial pressure, and when the right heart fails, the elevated pressures result in increased CVP readings. This increase indicates fluid overload and is an important marker for assessing the severity of right heart dysfunction.

The pulmonary artery catheter can provide numerous hemodynamic values, including CVP and pulmonary capillary wedge pressure (PCWP), and in the context of right heart failure, the PCWP might remain normal or even be decreased compared to the CVP. This is because the left side of the heart, while potentially affected, is not the primary issue in right heart failure, hence PCWP might not exhibit the same elevations as CVP.

Heart rate generally does not decrease in right heart failure; it may increase in response to decreased cardiac output. Similarly, systemic blood pressure often does not rise; it may actually decrease due to reduced forward flow from the heart. Therefore