Pericardiocentesis – Procedure, purpose and results

Overview

When a person’s heart accumulates excess fluid in the pericardium — the sac surrounding the heart — the fluid must be drained. The process of draining the fluid is known as pericardiocentesis. The procedure can save a patient’s life if the patient suffers from excess fluid in the pericardium and cardiac tamponade (the heart has no room to function normally).

This blog is a comprehensive guide to understanding pericardiocentesis, the procedure, purpose and results.

What is pericardiocentesis?

Pericardiocentesis is a procedure that drains the excess fluid in the pericardium. The pericardium is a sac-like membrane that surrounds the heart. The doctor drains the fluid in the bag using a needle and catheter.

What factors contribute to the need for pericardiocentesis?

The fluid buildup around the heart causes shortness of breath and chest pain. Sometimes the fluid accumulates even after medication, leading to a life-threatening illness. Therefore, the doctor drains the fluid through pericardiocentesis at the earliest. The procedure can also help determine the source of the excess fluid. The pericardium becomes filled with fluid (pericardial effusion) due to several factors, including:

  • Infection of the heart or pericardial sac
  • cancer
  • Inflammation of the bag
  • Injury
  • Diseases of the immune system
  • Reactions to certain medications
  • Radiation
  • Metabolic causes, such as renal failure with uremia

What happens before the pericardiocentesis procedure?

The patient must be fasted for at least 6 hours before the procedure. For treatment, consult the doctor before you stop taking medicines for other medical problems.

Before the procedure, the doctor may request additional tests. These can include the following:

  • X-ray of the chest
  • An electrocardiogram (ECG) to assess the heart rhythm
  • Blood tests determine a person’s overall health.
  • An echocardiogram assesses blood flow through the heart and the fluid around it.
  • If necessary, a CT scan or an MRI for additional information about the heart
  • Cardiac catheterization is a procedure that measures the pressure in the heart.

How is the pericardiocentesis procedure performed?

The patient should lie on an exam table at a 60-degree angle. If the patient experiences a severe drop in blood pressure or a slowed heart rate during surgery, the doctors may give intravenous fluids or prescribe medication. A numbing agent is applied to the skin under and around the breastbone. The patient remains conscious during the procedure.

The pericardial sac is ruptured with a needle and then guided inside using an echocardiogram. The patient may feel slight pressure during this procedure. It allows the doctor to see a moving image of the heart, which helps monitor fluid drainage. After inserting the needle, the needle is replaced with a catheter. It takes 20 to 60 minutes to complete the entire procedure.

The catheter remains in the patient’s chest for a few hours to allow fluid to drain into a container. Once the fluid has been removed from the bag, the cardiologist will remove the catheter. Pericardiocentesis isn’t the only method of removing fluid around your heart. But this method is preferred because it is less invasive than surgery. Sometimes doctors surgically drain the fluid in cases of chronic inflammation or fluid buildup, in those who need to have part of the pericardium removed, or in individuals whose fluid has certain characteristics.

When should a patient seek medical attention?

If a patient experiences symptoms of cardiac tamponade, infection, or sepsis, immediate medical attention is required.

The following are the symptoms of cardiac tamponade

  • chestpain
  • Breathing difficulties
  • Breathing unusually fast
  • Periods of fainting and dizziness
  • Dizziness
  • Palpitations or rapid heartbeat

The following are the symptoms of infection and sepsis. Sepsis is a life-threatening condition.

  • Redness or swelling near the needle entry point
  • Fever or chills
  • Confusion or disorientation
  • The skin becomes warm to the touch around the needle site.

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What are the risks of pericardiocentesis?

Every process carries a certain amount of risk. Pericardiocentesis carries the following risks:

  • Puncture of the heart, which may require surgery
  • Injury to the liver
  • Excessive bleeding puts a strain on the heart and hinders its ability to function normally.
  • There is air in the chest cavity
  • infection
  • Abnormal heartbeats (which in rare cases can cause death)
  • Fluid in the lungs due to heart failure (rare)

There is also the possibility of the fluid around the heart building up again. If this happens, the patient may need to repeat the treatment or have all or part of the pericardium removed.

What does an abnormal result of a pericardiocentesis mean?

The doctor may be able to pinpoint the cause of fluid retention. Discuss the results with the doctor to determine the significance and whether the condition may return. Doctors can guide patients through the treatment options.

What to expect after the procedure?

After the procedure, the patient can resume normal activities. The doctor usually advises not to exercise for a while. Call the doctor if the patient develops a fever, increased drainage or bleeding from the needle insertion site, chest pain, or other serious symptoms. Follow the healthcare provider’s advice for medications, exercise, diet, and wound care. After pericardiocentesis, many people report that their symptoms have improved.

Conclusion

Pericardiocentesis is a life-saving procedure. The procedure relieves the heart of the pressure of the excess fluid around it and allows the heart to pump normally.

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