Pericardiocentesis
(Pericardial Tap; Cardiac Needle Aspiration)
Definition
Pericardiocentesis is a procedure to remove fluid buildup from the sac around the heart. This is done with a needle.
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Reasons for Procedure
Pericardiocentesis may be used to:
- Treat cardiac tamponade—life-threatening pressure on the heart from fluid buildup
- Diagnose the cause of fluid buildup
Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Bleeding
- Damage to other organs or structures
- Infection
- Disruption of the heart’s normal rhythm
Things that may raise the risk of problems are:
What to Expect
Prior to Procedure
The doctor may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
- Fasting before the procedure, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from the procedure
- Tests that will need to be done before the procedure
Anesthesia
Medicine will help you relax. You will be awake during the procedure. The doctor will give local anesthesia—the area will be numbed.
Description of Procedure
A needle will be inserted into the chest. It will be slowly moved toward the heart. Ultrasound and possibly fluoroscopy will help guide the needle to the correct place. The needle will be passed into the pericardial sac.
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 enough fluid is collected or drained, 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.
Sometimes the catheter is left in place. This will let draining continue over several hours or days.
How Long Will It Take?
About 20 to 60 minutes
Will It Hurt?
Some feel pain or pressure when the needle is inserted. Pain medicine can help.
Average Hospital Stay
The length of stay varies from one day to several days.
Post-procedure Care
During your stay, the hospital staff will take steps to lower your risk of infection such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to lower your risk of infection such as:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
Call Your Doctor
Call your doctor if you are not getting better or you have:
- Signs of infection, such as fever or chills
- Excess bleeding, redness, swelling, or discharge from the insertion site
- Pain that you cannot control with the medicines
- Cough, problems breathing, or chest pain
- Lasting nausea or vomiting
- Lightheadedness
If you think you have an emergency, call for medical help right away.
RESOURCES:
American Heart Association
http://www.heart.org
National Heart, Lung, and Blood Institute
https://www.nhlbi.nih.gov
CANADIAN RESOURCES:
Health Canada
https://www.canada.ca
Heart and Stroke Foundation of Canada
http://www.heartandstroke.ca
REFERENCES:
Cardiac tamponade. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/injuries-poisoning/thoracic-trauma/cardiac-tamponade. Accessed September 9, 2021.
Heart inflammation. National Heart Lung and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/heart-inflammation. Accessed September 9, 2021.
Luis SA, Kane GC, et al. Overview of optimal techniques for pericardiocentesis in contemporary practice. Curr Cardiol Rep. 2020;22(8):60.
Pericardial effusion and tamponade. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/pericardial-effusion-and-tamponade. Accessed September 9, 2021.
Pericardiocentesis. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/diseases/17353-pericarditis Accessed September 9, 2021.
Pericardiocentesis. University of Rochester Medical Center website. Available at: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=135&contentid=361. Accessed September 9, 2021.
Last reviewed July 2021 by EBSCO Medical Review Board Nicole Meregian, PA Last Updated: 9/9/2021