Pericardiocentesis, also called a pericardial tap, is an invasive procedure in which a needle and catheter removes fluid from the sac around the heart. The fluid is tested for signs of heart infection like pericarditis (inflammation of the sac), congestive heart failure, heart attack, or 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.
I had my first heart attack 26 years ago, when I was 52. I was very active
then, sometimes jogging and often walking long distances. But I was also on the
congressional staff in Washington, and the day leading up to the attack was
even more hectic than usual. My boss was introducing major legislation, and I
had crafted an important floor speech. I didn’t have time for regular meals and
ate a huge cheeseburger for dinner, then smoked three or four cigarettes.
It happened about 3 in the morning...
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.
You can wear whatever you like to the hospital. You will change into a hospital gown for the procedure.
Leave all valuables at home.
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.
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) 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 will be removed.
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: