Heart Disease and Pericardiocentesis

Pericardiocentesis, also called a pericardial tap, is a procedure in which a needle and catheter remove fluid from the pericardium, the sac around your heart. The fluid is tested for signs of infection, inflammation, and the presence of blood and cancer.

Occasionally, pericardiocentesis is done in an emergency to treat something called cardiac tamponade, a life-threatening rapid buildup of fluid around the heart that weakens its pumping. The procedure relieves pressure there.

Why Is It Performed?

Your doctor uses it to:

• Find out if the fluid around your heart is caused by problems such as infection or cancer
• Relieve symptoms, like shortness of breath, that are caused by the fluid around your heart

How Do I Prepare for It?

Your doctor or nurse will tell you what you can and can’t eat or drink before it.

• Ask your doctor what medications should be taken on the day of your procedure.
• If you have diabetes, ask your doctor how to adjust your meds the day of your test.
• Tell your doctor and nurses if you are allergic to anything.
• Bring all your medicines and any previous test results.
• You may be admitted to the hospital afterward.
• Bring someone with you to take you home.

What to Expect

You will wear a hospital gown during the procedure. The room will be cool and dimly lit. You will lie on a special table in the cardiac catheterization lab. You will get a mild sedative to relax you, but you will be conscious during the procedure. An IV (intravenous) line is inserted into your hand or arm 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) will be threaded into the sac around your heart. The doctor may use an X-ray or echocardiogram machine to make sure the catheter is in the right spot. The doctor will then drain the fluid around your heart.

When the fluid has been removed, the catheter may be removed. Sometimes, it’s left in place for 24 to 48 hours for more drainage and to be sure that the fluid does not return.

The whole thing takes about 20 to 60 minutes to perform.

After the Procedure

Your doctor will monitor you for several hours. If the operation isn't successful, your doctor may need to do more procedures to drain fluid from around the heart (pericardiotomy) or to thin out the pericardium to relieve pressure (pericardiectomy).

What Are the Risks?

Pericardiocentesis is fairly safe, especially when imaging is used to guide the needle. But this procedure may:

• Bring on an irregular heart rhythm
• Cause cardiac arrest
• Cause a heart attack
• Puncture the heart, liver, lung, or stomach

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