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    Pericardiocentesis

    Pericardial tap; Percutaneous pericardiocentesis

    Pericardiocentesis is a procedure that uses a needle to remove fluid from the pericardial sac, the tissue that surrounds the heart.

    How the Test is Performed

    The procedure is usually done in an intensive care unit's procedure room or even at the bedside.

    A health care provider will put an IV into your arm in case fluids or medicines need to be given through a vein. For example, medication may be given if your heart beat slows or your blood pressure drops during the procedure.

    The health care provider will clean an area just below the breastbone and apply numbing medication (anesthetic). The doctor will insert a needle and guide it into tissue that surrounds the heart. Echocardiography is used to help the doctor see the needle and any fluid drainage. An electrocardiogram (ECG) may also be used to help with positioning.

    Once the needle has reached the correct area, it is removed and replaced with a tube called a catheter. Fluid drains through this tube into containers. Usually, the pericardial catheter is left in place so draining may continue for several hours.

    Surgical pericardiocentesis may be necessary in difficult cases. This is a more invasive procedure, which may require generalanesthesia.

    How to Prepare for the Test

    You may not be able to eat or drink for 6 hours before the test. You must sign a consent form.

    How the Test Will Feel

    You may feel pressure as the needle enters. Some people have chest pain, which may require pain medication.

    Why the Test is Performed

    This test may be done to remove and examine fluid that is pressing on the heart. It is usually done to evaluate the cause of a chronic or recurrent pericardial effusion.

    It may also be done to treat cardiac tamponade.

    Normal Results

    There is normally a small amount of clear, straw-colored fluid in the pericardial space.

    What Abnormal Results Mean

    Abnormal findings may indicate the cause of pericardial fluid accumulation, such as:

    • Cancer
    • Cardiac perforation
    • Cardiac trauma
    • Congestive heart failure
    • Pericarditis
    • Rupture of a ventricular aneurysm

    Risks

    • Bleeding
    • Collapsed lung
    • Heart attack
    • Infection (pericarditis)
    • Irregular heartbeats (arrhythmias)
    • Puncture of the heart muscle, coronary artery, lung, liver, or stomach
    • Pneumopericardium (air in the pericardial sac)

    References

    LeWinter MM, Tischler MD. Pericardial diseases. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap75.

    Little WC, Oh JK. Pericardial diseases. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 77.

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    • Aneurysm description

      Animation

    • Heart, front view

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    • Pericardium

      illustration

    • Aneurysm description

      Animation

    • Heart, front view

      illustration

    • Pericardium

      illustration

    Tests for Pericardiocentesis

    Review Date: 6/7/2012

    Reviewed By: Glenn Gandelman, MD, MPH, FACC Assistant Clinical Professor of Medicine at New York Medical College, and in private practice specializing in cardiovascular disease in Greenwich, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

    The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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