Is it just a simple right heart catheterisation ?

Image in Interventional Cardiovascular Medicine: what is displayed on this image? ... and do not hesitate to comment on how you would treat this case!

48-year-old male patient. Addict. From the age of 45, he started progressive dyspnea, accompanied by cyanosis and cough.An echocardiogram was performed, showing pulmonary hypertension with PSAP 57 mm Hg.He was referred for confirmation of pulmonary hypertension by right heart catheterization. During the procedure, with no possibility of advancing the Swan-Ganz catheter with clear anatomy, it was decided to perform a pulmonary angiogram.

An image is worth a 1,000 words: tell us what you see in this image!

Authors

Cataldo Pabla¹, Herrera Matias¹, Dauvergne Christian¹, Mendez Manuel¹, Pineda Fernando¹, Uriarte Polentzi¹, Sandoval Jorge¹

1. Hospital del Torax, Santiago, CHILE