The pericardial sac surrounds the heart. It normally contains a small amount of fluid. Pericardiocentesis is the withdrawal of fluid from this sac with a needle.
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Pericardiocentesis may be used as a treatment. If too much fluid builds up in the sac, this can put extra pressure on the heart. This is known as cardiac tamponade . It is a life-threatening condition. Withdrawing some of the fluid will help to relieve the pressure on the heart.
Pericardiocentesis may also be used to diagnose the cause of fluid buildup. Fluid buildup is known as pericardial effusion. The buildup can be caused by an infection, cancer, trauma, autoimmune disorders, or drug use . It may also indicate the presence of rheumatoid arthritis , heart attack , or kidney failure .
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
Pericardiocentesis may be a scheduled or emergency procedure. This can have an impact on which tests are done prior to the procedure. The following tests may be conducted prior to your procedure:
Leading up to your procedure:
Light sedation will be given to help you relax. You will be awake during the procedure. A local anesthesia will be injected at the insertion site. It will numb an area on your chest.
Your heart will be monitored. The needle will be inserted into the chest. It will be slowly moved toward the heart. Ultrasound and possibly fluoroscopy will be used to help guide the needle to the correct location. The needle will be passed into the pericardial sac, but no further.
Once in the pericardial sac, the fluid will be removed. The needle may be used, or a catheter tube may be inserted over the needle. After some fluid is collected or enough of the fluid has drained out, the needle or catheter will be removed. Pressure will be applied to the injection site for several minutes. This is done to stop the bleeding.
In some cases, your doctor may leave the catheter in place. This will allow draining to continue over several hours or days.
You will have a chest x-ray to make sure your lung has not been punctured. You will be closely monitored for several hours after the procedure. Your pulse, blood pressure, and breathing will be checked regularly.
The fluid removed from the pericardial sac is sent to a lab to be analyzed.
About 20-60 minutes
You may feel pain when the needle is inserted.
Hospital stay can vary from one day to several days. If the catheter remains in place to continue draining fluid, you may need to stay in the hospital several days.
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chances of infection such as:
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
If you think you have an emergency, call for medical help right away.
American Heart Association
National Heart, Lung, and Blood Institute
Heart and Stroke Foundation of Canada
Brockman RG, Ziskind AA. Pericardiocentesis and associated treatment of pericardial effusion. Cardiac Intensive Care. 1998;657-663.
Pericardial effusion. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 15, 2010. Accessed January 23, 2013.
Pericardiocentesis. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/services/pericardiocentisis. Accessed December 30, 2014.
Spodick DH. Acute cardiac tamponade. N Engl J Med. 2003;349(7):684-690.
Tibbles CD, Porcaro W. Procedural applications of ultrasound. Emerg Med Clin North Am. 2004;22(3):797-815.
What is pericarditis. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/More/What-is-Pericarditis_UCM_444931_Article.jsp. Updated July 29, 2014. Accessed December 30, 2014.
6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed December 2014 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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