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Pericardial Drainage

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 cardiologist, a cardiovascular surgeon, or an emergency medicine doctor.

During the 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.

In 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.

A 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 hours.

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.

Risks

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 to repair.

WebMD Medical Reference from Healthwise

Last Updated: June 13, 2012
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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