Early diagnosis of the older cardiac patient with multiple disorders

In the critically ill elderly patient, multiple organ system involvement is common. The presence of acute--or acute on chronic--cardiac, pulmonary, and renal disease in the same patient makes clinical evaluation for heart failure or volume depletion notoriously difficult. When the clinician is faced with a bewildering array of hemodynamic possibilities in a critically ill patient, the Swan-Ganz catheter may allow a baseline definition of the patient's volume status and cardiac output, on which further therapy and prognosis can be based.