To the Editor.—
Since its introduction in 1970, the Swan-Ganz catheter has proved extremely useful in the hemodynamic evaluation of cases of shock and myocardial infarction.1 Under most circumstances, it can be passed at the bedside (under hemodynamic monitoring alone) with ease. However, some complications of catheter passage have been documented, including ventricular fibrillation,2 intracardiac knotting,3,4 and atrial arrhythmias.5 We describe a previously unreported complication— entanglement of a Swan-Ganz catheter around a papillary muscle to the right ventricle.
Report of a Case.—
A 57-year-old man had a history of hypertension and a cerebrovascular accident eight years prior to admission. On the day of admission he complained of crushing substernal chest pain. His initial ECG showed an acute posterior- and lateral-wall myocardial infarction. He was admitted to the coronary care unit and had an uneventful initial course except for a period of transient atrial fibrillation. Serial enzyme
Schwartz KV, Garcia FG. Entanglement of Swan-Ganz Catheter Around an Intracardiac Structure. JAMA. 1977;237(12):1198–1199. doi:10.1001/jama.1977.03270390014003
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