Swan-Ganz Hemodynamics Calculator

Swan-Ganz Calculator

Hemodynamic Inputs

Enter measured values

Patient & Lab Data

HeightUsed to auto-calculate BSA cm

WeightUsed to auto-calculate BSA kg

Body surface areaMosteller formula m²

HemoglobinHgb g/dL

Arterial saturationSaO₂ / SpO₂ %

Venous saturationSvO₂ / ScvO₂ %

Systemic Arterial Pressure

Systolic pressureABP systolic mmHg

Diastolic pressureABP diastolic mmHg

Mean arterial pressureCalculated from systolic and diastolic pressure mmHg

PA Catheter

Right atrial pressureCVP / RAP mmHg

PA systolic pressurePAPs mmHg

PA diastolic pressurePAPd mmHg

Mean PA pressureCalculated from PA systolic and diastolic pressure mmHg

Wedge pressurePAWP / PCWP mmHg

Thermodilution COEntered measured TD CO L/min

Calculated Hemodynamics

Primary display: Fick

Flow and Perfusion

Cardiac OutputCO

--L/min

Reference: 4–6 L/min

Cardiac IndexCI

--L/min/m²

Reference: 2–4 L/min/m²

Venous SaturationSvO₂

--%

Reference: 65–75%

Cardiac Power OutputCPO

--W

Severe LV dysfunction concern below 0.6 W

Filling Pressures

Right Atrial PressureRAP

--mmHg

Reference: 1–6 mmHg

Wedge PressurePCWP

--mmHg

Reference: 6–11 mmHg

RA to PCWP RatioRAP/PCWP

Higher values suggest disproportionate right-sided congestion

PA PressureS/D/M

--mmHg

Displayed as systolic/diastolic/mean

Vascular Resistance and RV Function

Systemic Vascular ResistanceSVR

--dyn·s/cm⁵

Reference: 900–1400

Pulmonary Vascular ResistancePVR

--WU

Reference: ≤2 WU · >2 WU is elevated

PA Pulsatility IndexPAPi

Severe RV dysfunction concern below 0.9

Transpulmonary GradientTPG

--mmHg

mPAP − PCWP · >12 suggests pulmonary vascular remodeling

Hemodynamic Interpretation

Enter the measured hemodynamic values and select Calculate Hemodynamics.

Swan Interpretation

Hemodynamic Pattern	RAP / CVP	PCWP	CI	SVR	SvO₂	PVR	PAPi	RAP/PCWP	CPO	Typical Interpretation
Low-output / shock profiles
Cardiogenic Shock Biventricular congested low-output profile	↑	↑	↓ <2.2	↑ >1400	↓	Normal or ↑	Normal or ↓	Variable	↓ <0.6 severe	Low forward flow with elevated filling pressures and compensatory vasoconstriction. CI <1.8, CPO <0.6 W, MAP <65, or SvO₂ <60% strengthen the poor-perfusion signal.
LV-Predominant Failure Left-sided congestion	Normal or ↑	↑ >15	↓	↑	↓	Normal or ↑	Usually preserved	Usually <0.8	↓	Elevated left-sided filling pressure with reduced forward flow and increased LV afterload. Think LV failure when PCWP elevation is disproportionate to RAP.
RV-Predominant Failure Disproportionate right-sided congestion	↑ >8	Normal or mildly ↑	↓	Normal or ↑	↓	Often ↑	↓ <0.9 concerning	↑ ≥0.8 concerning	Normal or ↓	Elevated RAP with relatively lower PCWP suggests disproportionate RV congestion. Low PAPi, elevated RAP/PCWP, and/or elevated PVR strengthen the RV failure pattern.
Mixed Cardiogenic + Distributive Pump failure plus vasodilation	Variable	Variable	↓	↓ <900	Variable	Variable	Variable	Variable	↓	Low cardiac output together with low SVR suggests simultaneous pump failure and vasodilatory/distributive physiology.
Hypovolemia / Underfilling Low-preload low-output profile	↓ <3	↓ <6	↓	↑	↓	Normal or ↓	Usually preserved	Variable	↓	Low right- and left-sided filling pressures with low output and compensatory vasoconstriction. Compatible with hypovolemia or excessive preload reduction.
Distributive / Vasodilatory Classic high-output phenotype	↓ or Normal	↓ or Normal	↑ >3.5 typical	↓ <900; <700 marked	Normal or ↑	Normal or ↓	Usually preserved	Variable	Normal or ↑	High forward flow with reduced systemic vascular resistance. Markedly low SVR strongly supports vasodilatory physiology.
Congestion and pressure patterns
Congested, Preserved Flow	↑	↑	Normal	Variable	Usually preserved	Variable	Variable	Variable	Usually preserved	Elevated biventricular filling pressures without reduced calculated cardiac index. Represents congestion without a dominant low-output phenotype.
Tamponade Pattern Pressure-equalization clue	↑ typically ≥10	↑ typically ≥10	↓	↑	↓	Variable	Often ↓	Often ↑	↓	Elevated RAP and PCWP that are close together suggest pressure equalization. RAP and PCWP within 3 mmHg when both are ≥10 mmHg triggers a tamponade clue. Not diagnostic alone.
Pulmonary hypertension patterns
Precapillary PH	Variable	≤15	Variable	Variable	Variable	↑ >2 WU	May ↓ with RV failure	May ↑ with RV failure	Variable	mPAP >20 mmHg with PCWP ≤15 mmHg and elevated PVR. Supports precapillary pulmonary hypertension physiology.
Isolated Postcapillary PH	Normal or ↑	↑ >15	Variable	Variable	Variable	≤2 WU	Usually preserved	Variable	Variable	mPAP >20 mmHg with elevated PCWP but without significantly elevated PVR. Supports isolated postcapillary pulmonary hypertension.
Combined Post + Precapillary PH	Normal or ↑	↑ >15	Variable or ↓	Variable	Variable	↑ >2 WU	May ↓	May ↑	Variable	mPAP >20 mmHg with elevated PCWP and elevated PVR. Supports combined postcapillary and precapillary pulmonary hypertension.

Swan Basics

CXR Placement

Path: SVC → RA → RV → PA → branch
Ideal tip: Proximal R/L pulmonary artery, ~3–5 cm beyond carina, near hilum
Too proximal: In RV → arrhythmia risk
Too distal: In segmental PA → rupture risk

Equations

Cardiac output (CO)

CO (L/min) = (125 × BSA) / [(SaO2 − ScvO2) × 1.36 × 10 × Hgb]

Cardiac index (CI)

CI (L/min/m²) = CO / BSA

Systemic vascular resistance (SVR)

SVR (dynes·sec/cm^5) = 80 × (MAP − CVP) / CO

Pulmonary vascular resistance (PVR)

PVR (Wood units) = (PAmean − PCWP) / CO

Transpulmonary gradient (TPG)

TPG (mmHg) = mPAP − PCWP
Common bedside reference: ≤12 mmHg. Elevated TPG suggests pulmonary pressure beyond passive left-sided pressure transmission, but current PH classification relies on PVR rather than TPG.

Cardiac power output (CPO)

CPO = (MAP × CO) / 451

Pulmonary artery pulsatility index (PAPI)

PAPI = (PAPs − PAPd) / CVP

References

Swan, H. J. C., Ganz, W., Forrester, J., Marcus, H., Diamond, G., & Chonette, D. (1970). Catheterization of the heart in man with use of a flow-directed balloon-tipped catheter. New England Journal of Medicine, 283(9), 447–451. https://doi.org/10.1056/NEJM197008272830902
Forrester, J. S., Diamond, G., Chatterjee, K., & Swan, H. J. C. (1976). Medical therapy of acute myocardial infarction by application of hemodynamic subsets. New England Journal of Medicine, 295(24), 1356–1362. https://doi.org/10.1056/NEJM197612092952406
Stevenson, L. W., & Perloff, J. K. (1989). The limited reliability of physical signs for estimating hemodynamics in chronic heart failure. JAMA, 261(6), 884–888. https://doi.org/10.1001/jama.1989.03420060100040
Nohria, A., Tsang, S. W., Fang, J. C., Lewis, E. F., Jarcho, J. A., Mudge, G. H., & Stevenson, L. W. (2003). Clinical assessment identifies hemodynamic profiles that predict outcomes in patients admitted with heart failure. Journal of the American College of Cardiology, 41(10), 1797–1804. https://doi.org/10.1016/S0735-1097(03)00309-7
Mendoza, D. D., Cooper, H. A., & Panza, J. A. (2007). Cardiac power output predicts mortality across a broad spectrum of patients with acute cardiac disease. American Heart Journal, 153(3), 366–370. https://doi.org/10.1016/j.ahj.2006.11.014
Kang, G., Ha, R., Banerjee, D., & Pulmonary Artery Pulsatility Index Investigators. (2016). Pulmonary artery pulsatility index predicts right ventricular failure after left ventricular assist device implantation. Journal of Heart and Lung Transplantation, 35(1), 67–73. https://doi.org/10.1016/j.healun.2015.06.007
Bertaina, M., Galluzzo, A., Rossello, X., Omedè, P., Montefusco, A., Totaro, S., Bocchino, P. P., Frigo, A. C., Iannaccone, M., De Ferrari, G. M., & D’Ascenzo, F. (2022). Pulmonary artery catheter monitoring in patients with cardiogenic shock: Time for a reappraisal? Cardiac Failure Review, 8, e15. https://doi.org/10.15420/cfr.2021.18
Humbert, M., Kovacs, G., Hoeper, M. M., et al. (2022). 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. European Heart Journal, 43(38), 3618–3731. https://doi.org/10.1093/eurheartj/ehac237
Heidenreich, P. A., Bozkurt, B., Aguilar, D., et al. (2022). 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. Circulation, 145(18), e895–e1032. https://doi.org/10.1161/CIR.0000000000001063
Naidu, S. S., Baran, D. A., Jentzer, J. C., et al. (2022). SCAI SHOCK Stage Classification Expert Consensus Update. Journal of the Society for Cardiovascular Angiography & Interventions, 1(5), 100008.