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Heart Disease and Pericardiocentesis

Pericardiocentesis, also called a pericardial tap, is an invasive procedure in which a needle and catheter remove fluid from the sac around the heart. The fluid is tested for signs of infection, inflammation, presence of blood, and cancer.

Occasionally, pericardiocentesis is performed on an emergency basis to treat a condition called cardiac tamponade, a life-threatening, rapid buildup of fluid around the heart that weakens its pumping ability. The procedure relieves pressure on the heart.

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Why Is Pericardiocentesis Performed?

Your doctor uses pericardiocentesis to:

  • Determine cause of fluid around the heart, such as infection or cancer.
  • Relieve symptoms, such as shortness of breath, caused by having fluid around the heart.

 

 

To Prepare for Pericardiocentesis:

  • Your doctor or nurse will give you specific instructions about what you can and cannot eat or drink before the procedure.
  • Ask your doctor what medications should be taken on the day of your test.
  • If you have diabetes, ask your physician how to adjust your medications the day of your test.
  • Tell your doctor and/or nurses if you are allergic to anything.
  • Bring all medications and any previous test results.
  • You will need a companion to bring you home, or you may be admitted to the hospital after the procedure.

What To Expect During a Pericardiocentesis:

  •  The room will be cool and dimly lit. You will lie on a special table in the cardiac catheterization lab.
  • You will be given a mild sedative to relax you, but you will be awake and conscious during the entire procedure.
  • An IV (intravenous) line is inserted in your hand or arm in case fluids or medications are needed.
  • The doctor will use a local anesthetic to numb an area on your chest. A needle will be inserted and then a catheter (a thin plastic tube) will be threaded into the pericardial sac around your heart. The doctor may use an X-ray or echocardiography machine to make sure the catheter is positioned correctly. The doctor will drain the fluid that has collected around your heart.
  • When the fluid has been removed, the catheter may be removed. Sometimes it is left in place for more drainage.

 A pericardiocentesis takes about 20 to 60 minutes to perform. 

After the Pericardiocentesis:

Your doctor will monitor you for several hours after a pericardiocentesis. If the procedure isn't successful, more invasive treatments may be needed to drain fluid from around the heart or to strip the pericardium (sac lining the heart) to relieve fluid pressure.

What Are the Risks of Pericardiocentesis?

Pericardiocentesis is usually fairly safe, especially when imaging is used to guide the needle. But there is a risk that the procedure may:

  • Induce an irregular heart rhythm
  • Cause cardiac arrest
  • Cause a heart attack
  • Puncture the heart, liver, lung, stomach

 

 

WebMD Medical Reference

Reviewed by James Beckerman, MD, FACC on February 10, 2014
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