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May 29, 1972

Hemoptysis With Flow-Directed Cardiac Catheterization

JAMA. 1972;220(9):1246. doi:10.1001/jama.1972.03200090068020

To the Editor.—  Development of the flow-directed, balloon-tipped cardiac catheter (Swan-Ganz) has made possible the measurement of pulmonary artery and pulmonary artery wedge pressures during diagnostic cardiac catheterization and during monitoring of patients in intensive care units.1 Reported complications have been rare,1-3 however, the potential for serious complication still exists.In this case, significant hemoptysis and pulmonary alveolar hemorrhage were associated with pulmonary artery catheterization by a flow-directed, balloon-tipped catheter.

Report of a Case.—  A 59-year-old woman with rheumatic heart disease which had required mitral commissurotomy in 1962, and mitral and tricuspid annuloplasties in March 1971 was hospitalized for evaluation of unremitting, severe congestive heart failure in the postoperative period. Cardiac catheterization demonstrated pulmonary hypertension, but insignificant mitral or tricuspid regurgitation. At the time of catheterization it was impossible to measure directly a mitral-valve gradient. Because heart failure was unexplained by this procedure, right atrium catheterization with a