Pericardiocentesis
Alternative Names: Pericardial tap; Percutaneous pericardiocentesis
Pericardiocentesis is a procedure that uses a needle to remove fluid from the pericardial sac, the tissue that surrounds the heart.
Why is the Test Performed?
This test may be done to remove and examine fluid that is pressing on the heart. It is usually done to evaluate the cause of a chronic or recurrent pericardial effusion.
It may also be done to treat cardiac tamponade.
How is the Test Performed?
The procedure is usually done in an intensive care unit's procedure room or even at the bedside.
A health care provider will put an IV into your arm in case fluids or medicines need to be given through a vein. For example, medication may be given if you have slowing of the heartbeat or a drop in blood pressure during the procedure.
The health care provider will clean an area just below the breastbone and apply a local numbing medication (anesthetic). The doctor will insert a needle and guide it into the pericardial sac. Echocardiography is used to help position the needle and monitor fluid drainage, although electrocardiographic (ECG) leads may also be used to help with positioning.
Once the needle has reached the correct area, it is removed and replaced with a tube called a catheter. Fluid drains through this catheter into containers. Usually, the pericardial catheter is left in place so draining may continue for several hours.
Surgical pericardiocentesis may be necessary in difficult cases. In this procedure, the fluid is drained through a more invasive procedure that may require anesthesia.
Preparation for the Test
You may not be able to eat or drink for 6 hours before the test. You must sign a consent form.
How will the Test Feel?
You may feel pressure as the needle enters. Some people have chest pain, which may require pain medication.
Pericardiocentesis Risks
- Bleeding
- Collapsed lung
- Heart attack
- Infection (pericarditis)
- Irregular heartbeats (arrhythmias)
- Puncture of the heart muscle, coronary artery, lung, liver, or stomach
- Pneumopericardium (air in the pericardial sac)
Normal Results for Pericardiocentesis
There is normally a small amount of clear, straw-colored fluid in the pericardial space.
What Abnormal Results Mean
Abnormal findings may indicate the cause of pericardial fluid accumulation, such as:
- Cancer
- Cardiac perforation
- Cardiac trauma
- Congestive heart failure
- Pericarditis
- Rupture of a ventricular aneurysm
Related Images
Learn more about Pericardiocentesis
Reviewed By: Issam Mikati, MD, Associate Professor of Medicine, Feinberg School of Medicine, Director, Northwestern Clinic Echocardiography Lab, Northwestern University, Chicago, IL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Copyright 2012 A.D.A.M., Inc.
