How It Is Done
A diagnostic pericardial drainage is
usually done in a cardiac procedure room. If the drainage is being done to
relieve pressure on the heart, it may be done in an emergency room or in your
hospital room. This procedure is normally performed by a
cardiovascular surgeon, or an
emergency medicine doctor.
test, your heart is monitored using an
electrocardiogram (EKG, ECG). You will have an
intravenous (IV) line for any medicine that may need
to be given during the test. You may be given a mild
sedative to help you relax.
nonemergency situations, you will lean back at an angle on the bed or table.
Your chest will be shaved (if necessary), cleaned with an antiseptic solution,
and covered with sterile drapes.
local anesthetic will be injected to numb the skin and
deeper tissues, and then a long thin needle will be carefully inserted just
below your breastbone. In some cases the needle is inserted between your ribs
on the left side, over your heart. The needle is then slowly advanced through
the pericardial sac into the pericardial space. Your doctor may use an
echocardiogram or EKG to help guide the needle. Or an
X-ray camera may be used to guide the procedure.
The doctor then
guides a catheter, which is a thin plastic tube, along the needle into the
pericardial space. The fluid drains out through the catheter. Some fluid may be
saved and sent to a laboratory for tests. At different times during the
procedure, you may be asked to hold your breath. You must remain very still
throughout the procedure.
This procedure takes 10 to 20 minutes.
Sometimes your doctor will let the fluid drain through the catheter for a few
After some or all of the fluid is drained, the catheter is
removed, and pressure is applied to the injection site for several minutes to
stop any bleeding.
After the test, you will have a chest X-ray to
check for possible puncture and collapse of your left lung. You will be closely
observed for several hours, with frequent checks of your blood pressure, heart
rate, and breathing rate.
How It Feels
You will feel a brief stinging pain when
the local anesthetic is injected. When the needle is inserted into the
pericardial sac, you may feel pressure. You might feel pain in another location, such as your shoulder. You may also have some irregular or
"skipped" heartbeats during the test.
Tell your doctor right away if you have
severe chest pain or feel short of breath during or after the procedure.
Pericardial drainage can be a risky procedure,
though few serious or life-threatening complications occur when it is performed
by an experienced doctor. It is possible for the needle to puncture your heart
or one of your blood vessels. In rare cases, the needle may also puncture
your lung, your liver, or your stomach. These complications may require surgery