Right and left heart catheterisation note template
The pressure set and the derived calculations in one note.
- Indication
- Heart failure workup, pulmonary hypertension assessment, or pre-transplant evaluation.
- Access
- Internal jugular or femoral vein, radial or femoral artery, and the sheath sizes.
- Pressures
- RA mean; RV peak and end-diastolic; PA systolic, diastolic and mean; PCWP mean; aortic systolic, diastolic and mean; LV peak and end-diastolic.
- Calculations
- Cardiac output by thermodilution or Fick, cardiac index, pulmonary vascular resistance and systemic vascular resistance.
- Coronary angiography
- The coronary findings, where angiography was performed in the same sitting.
- Complications
- None, or the complication and how it was managed.
- Impression
- The haemodynamic picture in a sentence.
- Plan
- Medications, further procedures and follow-up.
Worked examples
Right + left heart catheterisation · post-capillary Hopkins, Wendy · 66F · Synthetic patient
Indication Unexplained dyspnoea, suspected pulmonary hypertension. Access Right internal jugular vein 7F, right radial artery 5F. Pressures (mmHg) RA mean 9. RV 38/10. PA 38/18, mean 26. PCWP mean 18. Aorta 128/72. LV 130/19. Calculations CO 4.8 L/min (thermodilution). CI 2.6. PVR 1.7 WU. SVR 1,360 dyn·s/cm⁵. Coronary angiography Unobstructed left and right coronary arteries. Complications None. Haemostasis achieved at both sites. Impression Isolated post-capillary pulmonary hypertension with elevated left-sided filling pressures. Plan Increase furosemide. Review in 6 weeks. Repeat study only if symptoms progress.
Right + left heart catheterisation · precapillary disease Barrett, Lynette · 54F · Synthetic patient
Indication Progressive dyspnoea with a dilated right ventricle on echocardiography. Access Right femoral vein 7F, right femoral artery 5F. Pressures (mmHg) RA mean 12. RV 68/12. PA 66/28, mean 42. PCWP mean 9. Aorta 118/68. LV 120/12. Calculations CO 3.4 L/min (Fick). CI 1.9. PVR 9.7 WU. SVR 1,710 dyn·s/cm⁵. Coronary angiography Not performed. Complications None. Venous site closed with manual pressure. Impression Precapillary pulmonary hypertension with a low cardiac index and a normal wedge pressure. Plan Referral to the pulmonary hypertension service for vasoreactivity testing. Commence furosemide. TTE in 8 weeks.
Right + left heart catheterisation · combined pre- and post-capillary Dunn, Arthur · 77M · Synthetic patient
Indication Breathlessness with preserved ejection fraction, to separate cardiac from pulmonary causes. Access Right internal jugular vein 7F, right femoral artery 5F. Pressures (mmHg) RA mean 14. RV 52/14. PA 50/24, mean 34. PCWP mean 24. Aorta 152/84. LV 156/22. Calculations CO 4.2 L/min (thermodilution). CI 2.1. PVR 2.4 WU. SVR 1,770 dyn·s/cm⁵. Coronary angiography Mild non-obstructive disease of the left anterior descending artery. Complications None. Impression Combined pre- and post-capillary pulmonary hypertension, PVR 2.4 WU, on a background of heart failure with preserved ejection fraction. Plan Titrate diuretic. BP target below 130 systolic. Empagliflozin 10 mg commenced. Review in 4 weeks with EUC.
