When is PAWP is higher than the LVEDP?
Pretty much anything that results in an obstruction (or reversal) of forward flow from the pulmonary circulation into the left ventricle will result in a PAWP higher than the LVEDP.
- Mitral stenosis (gradient across the mitral valve is high, LA pressure is increased)
- Atrial myxoma (same reason)
- Mitral regurgitation (large v waves interfere with wedge measurement, and LA pressure is high)
- Pulmonary fibrosis (obstruction to venous flow)
- Inappropriate placement (eg. into a high Wests zone)
- High PEEP
- High Auto-PEEP