Pericardiocentesis for fluid extraction and analysis
Pericardiocentesis or pericardial tap is a procedure during which the fluid is removed from the sac around the heart, the pericardium. It is done with a needle, a catheter and usually with a ultrasound to get a better view of the needle trajectory as well as to decrease the risk of complications.
In situations where is a need to draw more flud from the pericardium, similar procedure known as pericardial window is done. During this procedure, part of the pericardium is removed and the chest tube is placed, in order to drain more fluid.
WHAT IS IT USED FOR
Pericardiocentesis is used to:Find the cause of fluid build up around the heart, whether it is infection, autoimmune condition or cancerPreven heart attack or heart failure caused by fluid build upImprove pumping ability of the heart muscleRelieve some of the symptoms caused by fluid build up, such as shortness of breath
HOW TO PREPARE FOR PERICARDIOCENTESIS
First, you will need someone to take you home after the treatment. You should bring all the previous tests and tell your doctor which medications you are taking, before the test. The doctor will tell you which ones you can or can't take, in order to prevent any complications during the test.
This also applies for supplements. If you are allergic to anything, tell your doctor. Besides medications, foods you eat as well as what you drink, may also affect the test. You shouldn't eat or drink for 6 hours before the test. However, you can consult with doctor, regarding this one.
When it comes to clothes, you can wear whatever you want, since you will be given a gown, in the hospital.
WHAT TO EXPECT DURING PERICARDIOCENTESIS
You will lie down on a table after which the doctor will give you a mild sedative to help you relax. This will prevent moving and twitching during the process which is very important since a needle will be inserted into your heart. However, you will be awake and conscious during the process.
The doctor may also use local anesthetic to numb the area on your chest, where the needle will be inserted. An IV will be attached to your arm in order to administer the medications or the fluids intravenously, if needed.
While inserting a needle, the doctor may use ultrasound or x-ray to make sure that catheter is where it should be. After this, he will drain the fluid, accumulated around the heart. When all the fluid is removed, the catheter will be removed.
The procedure may last from 20 to 60 minutes, depending on the amount of fluid being extracted.
WHAT ARE THE RISKS OF PERICARDIOCENTESIS
Although the test is very safe, especially when done in combination with ultrasound or x-ray, there are a couple of risks involved. Procedure may:Trigger a heart attackLead to cardiac arrestInfectionBleedingCause irregular heart rhythmIf the needle is insterted the wrong way, it may puncture the heart, liver, lung or the stomach
WHAT TO EXPECT AFTER PERICARDIOCENTESIS
After the test, the doctor will monitor you for several hours. If the procedure hasn't been successful, another more invasive treatment may be needed to drain the fluid around the heart, in order to ease the pressure. In this case, procedure such as surgical pericardiocentesis or pericardial window may require anesthesia.
Although the test lasts from 20 to 60 minutes, the catheter can be left in place for several hours, in order to drain the fluid completly.
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