RHC may be useful for efficiently titrating the dosages of diuretic, vasodilator, inotropic and pressor medications in patients with shock or severe decompensated heart failure, or both. In contrast, RHC is not warranted for the routine management of pulmonary edema, even if endotracheal intubation and mechanical ventilation have been necessary. RHC is helpful in the management of patients with cardiac disease and failure who are undergoing noncardiac surgery, particularly patients with decompensated heart failure undergoing intermediate or high risk operation. RHC aids in risk stratification of patients who are considered for heart transplantation. Preoperative RHC identifies patients with high pulmonary vascular resistance and determines its reversibility in response to vasodilator agents.
Pericardial tamponade constitutes a special case of the diagnosis and management of heart failure.
Tamponade is suspected on clinical grounds and is best confirmed by echocardiography. RHC is warranted when clinical and echocardiographic findings are equivocal.