Pericardiocentesis is a procedure that uses a needle to remove fluid from the pericardial sac, the tissue that surrounds the heart.
Pericardial tap; Percutaneous pericardiocentesis
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 general anesthesia.
You may not be able to eat or drink for 6 hours before the test. You must sign a consent form.
You may feel pressure as the needle enters. Some people have chest pain, which may require pain medication.
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.
There is normally a small amount of clear, straw-colored fluid in the pericardial space.
Abnormal findings may indicate the cause of pericardial fluid accumulation, such as:
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.