Pericardiocentesis

What is pericardiocentesis?

Pericardiocentesis is procedure to remove fluid (pericardial effusion) from the sac around the heart (pericardium). This procedure is also called a pericardial tap.

When is it used?

Pericardiocentesis may be used to:

• Diagnose infection or cancer that may be causing fluid around the heart.
• Relieve symptoms, such as shortness of breath caused by having fluid around the heart. Sometimes it needs to be done in an emergency to treat a 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.

How do I prepare for the procedure?

You may be asked not to eat or drink anything for 12 hours before the procedure. If you are not staying in the hospital, arrange for someone to drive you home afterward.

Follow your healthcare provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery.

Ask your healthcare provider if you need to stop taking certain medicines for a while before the procedure. Your provider may recommend that if you need a minor pain reliever in the week before surgery, you should choose acetaminophen rather than aspirin, ibuprofen, or naproxen. Your provider may also advise avoiding medicines that may contain aspirin, such as nonprescription cold medicines. If you are taking daily aspirin, ask your provider if you need to stop taking it before your surgery. Avoiding these medicines helps avoid extra bleeding during surgery.

Follow any other instructions your healthcare provider may give you.

What can I expect?

You are given a sedative, which will make you feel relaxed, but you will stay awake. 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 echocardiogram (ultrasound) or an X-ray to make sure the catheter is in the proper place. The doctor will drain the fluid that has collected around your heart. When the fluid has been removed, the catheter will be removed. Sometimes the catheter is left in for a day or two.

What happens after the procedure?

The procedure takes about 20 to 60 minutes. You should avoid strenuous activity for the rest of the day to prevent bleeding where the catheter was inserted.

Ask your healthcare provider if you should take any precautions after the procedure, what symptoms to watch for, and when you should come back for a checkup.

What are the risks?

• The procedure can cause irregular heart rhythms, which could require treatment.
• While not common, a heart attack or stroke might be triggered by the procedure.
• The catheter could puncture the heart.

When should I call my healthcare provider?

Call your healthcare provider if you have:

• severe pain or bleeding from the puncture site
• increased swelling and tenderness where the needle was inserted.

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