Normal Pulmonary Artery Catheterization Pressure Values
In healthy individuals, normal mean pulmonary artery pressure (mPAP) is 14 ± 3 mmHg with an upper limit of normal at approximately 20 mmHg, and normal pulmonary capillary wedge pressure (PCWP) is ≤15 mmHg. 1, 2
Mean Pulmonary Artery Pressure (mPAP)
- Normal range: 14 ± 3 mmHg (range approximately 11-17 mmHg) 1, 2
- Upper limit of normal: ~20 mmHg 1, 2
- Values between 21-24 mmHg are of unclear clinical significance but warrant close monitoring in at-risk patients 1
- Pulmonary hypertension is defined as mPAP ≥25 mmHg by traditional criteria, though recent guidelines have lowered this threshold to >20 mmHg 1, 3, 2
Pulmonary Artery Systolic Pressure (PASP)
- Normal average: 21 ± 4 mmHg 2
- Upper limit of normal: ~30 mmHg 2
- Values >30 mmHg on echocardiography are generally outside the normal range and associated with increased mortality 2
Pulmonary Capillary Wedge Pressure (PCWP/PAWP)
- Normal range: ≤15 mmHg 1, 4, 5
- PCWP accurately reflects left atrial pressure under both normal and elevated conditions 4
- Pre-capillary pulmonary hypertension is defined by PAWP ≤15 mmHg (with mPAP ≥25 mmHg and PVR >3 Wood units) 1
- Post-capillary pulmonary hypertension is defined by PAWP >15 mmHg 1
Pulmonary Artery Diastolic Pressure (PADP)
- PADP should normally be equal to or slightly higher than PCWP 6
- When PCWP exceeds PADP, the wedge measurement is likely erroneous and catheter repositioning is needed 6
- When PADP exceeds PCWP by ≥6 mmHg, this indicates elevated pulmonary vascular resistance (mean 257 ± 145 dyne·s·cm⁻⁵) and is associated with significantly higher mortality (59% vs 34%) 6
Pulmonary Vascular Resistance (PVR)
- Normal range: 80-160 dyne·s·cm⁻⁵ (or ≤3 Wood units) 1, 6
- PVR >3 Wood units defines pulmonary arterial hypertension when combined with appropriate PAP and PCWP criteria 1
Clinical Caveats
Important measurement considerations:
- Right heart catheterization remains the gold standard for accurate pressure measurement and cannot be replaced by echocardiographic estimates 3
- PCWP measurements should always be compared to PADP to verify accuracy—if PCWP > PADP, the measurement is unreliable 6
- Simultaneous pressure acquisition yields better agreement between PCWP and left atrial pressure (bias ±1.98 mmHg) compared to measurements taken minutes apart 4
- In patients with suspected pulmonary hypertension, PCWP ≤15 mmHg has 89% sensitivity and 64% specificity for identifying true pre-capillary disease 5
- Even mild elevations in pulmonary artery pressure (mPAP 20-24 mmHg) are associated with increased mortality 2