Which condition is a contraindication for the use of a pulmonary artery catheter?

The use of a pulmonary artery catheter, also known as a Swan-Ganz catheter, is contraindicated in the presence of mitral valve stenosis due to the risk of complications that can arise from increased pulmonary artery pressure. In patients with mitral valve stenosis, there is already an obstruction to blood flow from the left atrium to the left ventricle, which can lead to elevated pressures in the pulmonary circulation. Inserting a pulmonary artery catheter may exacerbate this condition, potentially resulting in pulmonary congestion, hemorrhage, or even cardiac rupture.

Mitral valve stenosis can render the pulmonary circulation particularly sensitive to changes in pressure, and monitoring with a catheter in such a scenario could lead to serious adverse outcomes. The risks associated with manipulating the hemodynamics in these patients make it crucial to avoid the use of this catheter in their management.

In contrast, fluid overload, hepatic failure, and stable angina can be managed with careful monitoring and may not pose the same level of immediate risk associated with the insertion of a pulmonary artery catheter as in the case of mitral valve stenosis.