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Heart, front view
Heart, front view


Pericardium
Pericardium


Definition:

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



Alternative Names:

Pericardial tap; Percutaneous pericardiocentesis



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 you have slowing of the heartbeat or a drop in blood pressure during the procedure.

The health care provider will clean an area just below the breastbone and apply a local numbing medication (anesthetic). The doctor will insert a needle and guide it into the pericardial sac. Echocardiography is used to help position the needle and monitor fluid drainage, although electrocardiographic (ECG ) leads 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 catheter 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. In this procedure, the fluid is drained through a more invasive procedure that may require anesthesia .



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 Values:

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:



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


Special considerations:



References:

LeWinter MM. Pericardial Diseases. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007: Chap. 70.




Review Date: 5/12/2008
Reviewed By: Larry A. Weinrauch, MD, Assistant Professor of Medicine, Harvard Medical School, and Private practice specializing in Cardiovascular Disease, Watertown, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., 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. Call 911 for all medical emergencies. 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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