Pericardiocentesis

What Is Pericardiocentesis?

Pericardiocentesis is a medical procedure in which a needle is inserted between the ribs into the pericardial sac in order to drain fluid, blood, or air. It is usually performed on an outpatient basis for people with pericardial effusion, which is an accumulation of fluid around the heart.

Why Is Pericardiocentesis Necessary?

Pericardiocentesis is necessary to remove excess fluid from around the heart, as this can compress the heart, leading to dangerous changes in blood pressure. It can also be performed to collect fluid for analysis in order to diagnose any potential underlying causes. It may also be performed to reduce the risk of cardiac tamponade, which is a potentially life-threatening condition that occurs when fluid accumulates around the heart quickly and puts too much pressure on the heart.

When Is Pericardiocentesis Performed?

Pericardiocentesis is usually performed when other treatments have not been successful in resolving the issue. It is typically recommended for people with severe pericardial effusion that is associated with signs or symptoms of heart failure, such as shortness of breath, fatigue, and chest pain.

Types of Pericardiocentesis

There are two main types of pericardiocentesis:

• Closed pericardiocentesis – This procedure involves insertion of a needle into the pericardial sac without making an incision, and is usually performed with the aid of an ultrasound or x-ray.
• Open pericardiocentesis – This procedure involves making an incision in the pericardial sac in order to manually remove excess fluid or other material.

Preparation for Pericardiocentesis

Before the procedure, the doctor will do an overview of the patient’s medical history and symptoms. A physical exam may also be done to check the patient’s pulse, breathing, and fluid accumulation in the chest area. In some cases, other tests may be done, such as an electrocardiogram (ECG), echocardiogram, or X-ray.

Procedure for Pericardiocentesis

The procedure will begin with the patient lying down on a table, usually in the lateral decubitus position, which is lying on one side with the face up and the arm on the opposite side extended. Local anesthesia will be applied to the skin before insertion of the needle into the pericardial sac. The doctor will then guide the needle point into the pericardial sac, where it will be used to collect and drain the fluid.

Risks and Complications of Pericardiocentesis

Some risks associated with pericardiocentesis include bleeding, infection, pneumothorax, and cardiac arrhythmia. In rare cases, the procedure can cause the heart to go into cardiac arrest, and it can also cause damage to the heart or aorta.

Conclusion

Pericardiocentesis is an important medical procedure that can be used to drain excess fluid from around the heart, collect fluid for diagnostic purposes, and reduce the risk of cardiac tamponade. It is usually performed on an outpatient basis and involves insertion of a needle between the ribs into the pericardial sac. It is important to discuss the potential risks and benefits of the procedure with your doctor before undergoing the procedure.