(Pericardial Tap; Cardiac Needle Aspiration)
by Mary Calvagna, MS
The pericardial sac surrounds the heart. It normally contains a small amount of fluid. Pericardiocentesis is the withdrawal of fluid from this sac with a needle.
Reasons for Procedure
Pericardiocentesis may be used as a treatment. If too much fluid builds up in the sac, this can put extra pressure on the heart. This is known as cardiac tamponade. It is a life-threatening condition. Withdrawing some of the fluid will help to relieve the pressure on the heart.
Pericardiocentesis may also be used to diagnose the cause of fluid buildup. Fluid buildup is known as pericardial effusion. The buildup can be caused by an infection, cancer, trauma, autoimmune disorders, or drug use. It may also indicate the presence of rheumatoid arthritis, heart attack, or kidney failure.
Possible Complications TOP
If you are planning to have a pericardiocentesis, your doctor will review a list of possible complications, which may include:
Factors that may increase the risk of complications include:
What to Expect TOP
Prior to Procedure
Pericardiocentesis may be a scheduled or emergency procedure. This can have an impact on which tests are done prior to the procedure. The following tests may be conducted prior to your procedure:
Leading up to your procedure:
Light sedation will be given to help you relax. You will be awake during the procedure. A local anesthesia will be injected at the insertion site. It will numb an area on your chest.
Description of Procedure
You will lie on a table. An IV line will be inserted into your arm. The sedative will be delivered this way. The area where the needle will be inserted will be washed. Your heart will be monitored.
The needle will be inserted into the chest. It will be slowly moved toward the heart. Ultrasound and possibly fluoroscopy will be used to help guide the needle to the correct location. The needle will be passed into the pericardial sac, but no further.
Once in the pericardial sac, the fluid will be removed. The needle may be used, or a catheter tube may be inserted over the needle. After some fluid is collected or enough of the fluid has drained out, the needle or catheter will be removed. Pressure will be applied to the injection site for several minutes. This is done to stop the bleeding.
In some cases, your doctor may leave the catheter in place. This will allow draining to continue over several hours or days.
Immediately After Procedure
You will have a chest x-ray to make sure your lung has not been punctured. You will be closely monitored for several hours after the procedure. Your pulse, blood pressure, and breathing will be checked regularly.
The fluid removed from the pericardial sac is sent to a lab to be analyzed.
How Long Will It Take?
About 20-60 minutes
How Much Will It Hurt?
You may feel pain when the needle is inserted.
Average Hospital Stay
Hospital stay can vary from one day to several days. If the catheter remains in place to continue draining fluid, you may need to stay in the hospital several days.
When you return home, do the following to help ensure a smooth recovery:
Call Your Doctor TOP
After you leave the hospital, contact your doctor if any of the following occurs:
In case of an emergency, call for medical help right away.
American Heart Association
National Heart, Lung, and Blood Institute
Heart and Stroke Foundation of Canada
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Last reviewed November 2012 by Michael J. Fucci, DO
Last Updated: 11/26/2012