Pericardiocentesis of the Heart

What is pericardiocentesis?

Pericardiocentesis is a procedure that may be done to remove fluid from the sac around the heart. The sac around the heart is called the 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 fluid around the heart.

Sometimes the procedure needs to be done in an emergency to treat a cardiac tamponade. Cardiac tamponade is a life-threatening, rapid buildup of fluid around the heart that puts pressure on the heart muscle. The fluid makes it hard for the heart to pump blood to the rest of your body.

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 after the procedure, find 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 these reasons, 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 will be given a sedative. The sedative will make you feel relaxed, but you will stay awake. Your healthcare provider will use a local anesthetic to numb an area on your chest. He or she will insert a needle and then a catheter (a thin plastic tube) into the sac around your heart. Your provider may use an echocardiogram (ultrasound) or X-rays to make sure the catheter is in the right place. The catheter will be used to drain the fluid that has collected around your heart. Then the catheter will be removed, or it may be 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 benefits?

This procedure can help your healthcare provider diagnose a problem that may be causing fluid to build up around your heart or it may relieve symptoms you are having.

What are the risks?

• The procedure can cause irregular heart rhythms, which could require further 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 provider if you have:

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