Pericardiocentesis

A pericardial effusion develops when fluid fills the sac around the heart (the pericardium). The pericardial effusion can advance to a cardiac tamponade when the fluid accumulates rapidly and puts pressure on the heart. The pressure will weaken the ability of the heart to pump and lower blood pressure drastically. A tamponade is life-threatening.

When pericardial effusion develops, a pericardiocentesis (pericardial tap) is performed to remove the fluid and relieve the symptoms. Testing of the fluid may be needed to rule out infection or cancer. For a cardiac tamponade, the pericardiocentesis may be done on an emergent basis.

Pericardiocentesis is performed in the cath lab. The patient is conscious for the procedure but given a mild sedative through an IV to relax. A local anesthetic is injected into the chest to numb the area where the catheter (a thin plastic tube) will be introduced. The catheter is then maneuvered into the sac around the heart with the use of an echocardiogram machine to assure the correct position. The fluid is then removed. If any fluid remains, the catheter may be left in place for additional drainage. The entire procedure can last from 20 to 60 minutes. The patient is then monitored for several hours.