Pericardiocentesis, also called a pericardial tap, is an invasive procedure that involves using a needle and catheter to remove fluid (called a pericardial effusion) from the sac around the heart (the pericardium). The fluid may then be sent to a laboratory for tests to look for signs of infection or cancer.

Occasionally, pericardiocentesis is performed on an emergency basis to treat a condition called cardiac tamponade. This condition is a life-threatening, rapid buildup of fluid around the heart that puts pressure on the heart muscle, weakening its pumping ability and drastically lowering blood pressure.

Why Is Pericardiocentesis Performed?

Your doctor uses pericardiocentesis to:

  • Determine the cause of fluid around the heart.
  • Relieve symptoms, such as shortness of breath caused by having fluid around the heart.
  • Diagnose infection or cancer that may be causing fluid around the heart.
    Preparing for a Pericardiocentesis
  • You will wear a hospital gown during the procedure.
  • Your doctor or nurse will give you specific instructions about what you can and cannot eat or drink before the procedure.
  • Ask your doctor what medications should be taken on the day of your pericardiocentesis.
  • If you have diabetes, ask your physician how to adjust your medications the day of your test.
  • Tell your doctor and/or nurses if you are allergic to anything.
  • Bring all medications and any previous test results.
  • You will need a companion to bring you home.

What To Expect During a Pericardiocentesis

The pericardiocentesis takes about 30 to 60 minutes.

  • The room will be cool and dimly lit. You will lie on a special table in the cardiac catheterization laboratory.
  • You will be given a mild sedative to relax you, but you will be awake and conscious during the entire procedure.
  • An IV (intravenous) line is inserted in case fluids or medications are needed.
  • The doctor will use a local anesthetic to numb an area on your chest. A needle will be inserted and then a catheter (a thin plastic tube) into the pericardial sac around your heart. The doctor may use an X-ray or echocardiography machine to make sure the catheter is positioned correctly. The doctor will drain the fluid that has collected around your heart.
  • When the fluid has been removed, the catheter may be left in for 24-48 hours to be sure that the fluid does not return or it may be removed immediately after the procedure is over.

After the Pericardiocentesis

Your doctor will monitor you for several hours after pericardiocentesis. If the procedure isn't successful, more invasive treatments may be needed to drain fluid from around the heart (pericardiotomy) or to strip the pericardium away to relieve tamponade (pericardiectomy).

What Are the Risks of Pericardiocentesis?

Pericardiocentesis is usually relatively safe, primarily when imaging is used to guide the needle.

However, there is a risk that the procedure may:

  • Induce an irregular heart rhythm
  • Cause cardiac arrest
  • Cause a heart attack
  • Puncture the heart
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