What is Pericardiocentesis

Pericardiocentesis is a procedure that is used to remove fluid from the sac that surrounds the heart (pericardium). Pericardiocentesis is done by placing a needle into the pericardium.

This procedure may be done:

• To help determine the cause of a buildup of too much fluid around your heart (pericardial effusion). Checking the fluid under a microscope can help show what is causing the condition.
• To treat a pericardial effusion if the buildup of fluid is causing too much pressure around your heart (cardiac tamponade). This is an emergency procedure.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Problems may occur, including:

• Bleeding.
• Infection.
• Air entering the pericardium.
• Irregular heartbeats.
• Damage to a lung (collapsed lung).
• Damage to heart muscle.

What happens before the procedure?

Medicines

Ask your health care provider about:

• Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• Taking over-the-counter medicines, vitamins, herbs, and supplements.

General instructions

• Follow instructions from your health care provider about eating and drinking restrictions before the procedure.
• Ask your health care provider what steps will be taken to prevent infection. These may include:
  • Removing hair at the insertion site.
  • Washing skin with a germ-killing soap.
  • Taking antibiotic medicine.
• Plan to have someone take you home from the hospital or clinic.

What happens during the procedure?

• You will be positioned on a table.
• You will have patches (electrodes) placed on your chest to monitor your heart rate.
• An IV will be inserted into one of your veins.
• You will be given one or both of the following:
  • A medicine that helps you relax (sedative).
  • A medicine that numbs the area (local anesthetic).
• An imaging machine will be used to locate your pericardium. This may be done using:
  • An ultrasound (echocardiogram).
  • A type of X-ray (fluoroscopy).
• A long needle (cardiac needle) will be inserted into your pericardium. Fluid will be removed.
• If there is fluid that needs to drain over time, a thin tube (catheter) will be inserted as the needle is removed.
• A bandage (dressing) will be applied to the insertion site after the needle or catheter is removed.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.

Summary

• Pericardiocentesis is a procedure that is used to remove fluid from the sac that surrounds the heart.
• It may be done as an emergency procedure if you have a sudden buildup of fluid or blood around your heart.
• The fluid removed during this procedure will be checked under a microscope to help show what is causing the condition.
• Problems may occur during the procedure. These include developing an irregular heartbeat or having damage to a lung or heart muscle.

Pericardiocentesis, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Soreness at the puncture site.

Follow these instructions at home:

Puncture site care

• Follow instructions from your health care provider about how to take care of your puncture site. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
• Check your puncture area every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider when you can start taking showers.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Ask your health care provider whether you can taken medicines such as aspirin and ibuprofen. These medicines can cause bleeding after a procedure.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Rest at home and avoid vigorous activity for a few days. Return to your normal activities as directed by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you:

• Have a fever.
• Have redness, swelling, or pain at the site of your puncture.
• Have fluid, blood, or pus coming from your puncture site.
• Have a cough.

Get help right away if:

• You have chest pain.
• You have trouble breathing.
• Your heart pounds or feels like it is skipping beats (palpitations).
• You feel dizzy or light-headed.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• After your procedure, it is common to have soreness at the site where the needle was inserted.
• Follow instructions from your health care provider about how to take care of your puncture site.
• Take over-the-counter and prescription medicines only as told by your health care provider. You may be asked to avoid taking medicines such as aspirin and ibuprofen. These can cause bleeding after a procedure.
• Get help right away if you have palpitations, lightheadedness, chest pain, or trouble breathing.