Pericardial drainage (pericardiocentesis) is done to find the cause of fluid buildup around the heart and to relieve pressure on the heart. The tissue sac that surrounds the heart is called the pericardium. It protects the heart and parts of the major blood vessels connected to the heart. Normally, there is a small amount of fluid between this sac and the heart. This fluid surrounds and helps cushion the heart. It helps reduce friction between the heart and other structures in the chest when the heart beats.

Some diseases cause fluid to collect within the pericardium (pericardial effusion). Excess fluid can prevent normal filling of the heart, which can reduce the heart's ability to pump blood (cardiac tamponade).

Pericardial drainage may be done to find the cause of a pericardial effusion. During this test, a needle is inserted under the breastbone and into the pericardium to remove a sample of the fluid. The fluid is sent to a laboratory where it is measured and checked for blood, microorganisms (such as bacteria, fungi, or viruses), white blood cells, sugar (glucose), and cancer cells. In some cases, the pericardial fluid may be checked for other substances (such as carcinoembryonic antigen, or CEA).

Pericardial drainage may also be done to help relieve pressure on the heart. It is sometimes done in an emergency if a serious injury has occurred, such as a gunshot or stab wound to the chest or a massive heart attack. In these circumstances, blood or fluid can build up very rapidly in the pericardium. An emergency pericardial drainage can be done to remove the blood or excess pericardial fluid surrounding the heart.

Why It Is Done

Pericardial drainage is done to:

• Relieve pressure on the heart.
• Find the cause of pericardial effusion.
• Remove blood or excess fluid after a heart attack or a serious injury, such as a gunshot or stab wound.

How To Prepare

Tell your doctor if you:

• Are allergic to any medicines, including anesthetics.
• Take medicine to prevent blood clots, including anticoagulants (such as warfarin) or antiplatelets (such as clopidogrel or aspirin).
• Are taking antibiotics.
• Have had bleeding problems.

Unless the procedure is being done in an emergency, you will be asked to sign a consent form. Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form (What is a PDF document?) .

You may not be able to eat or drink for several hours before the test.

Some blood tests, including those to check for anemia and blood-clotting problems, may be done before the test.

Because this is a test involving your heart, you may have to stay overnight in the hospital to be monitored closely. If a drain is inserted during the test, you may have to stay for several days.