Pericardiocentesis

Pericardiocentesis

Pericardiocentesis is a medical procedure used to remove fluid from the pericardial cavity, the space around the heart enclosed by the pericardium. This procedure is typically performed to relieve pressure on the heart due to pericardial effusion or cardiac tamponade.

Indications

Pericardiocentesis is indicated in several clinical scenarios, including:

• Cardiac tamponade
• Large or symptomatic pericardial effusion
• Diagnostic evaluation of pericardial fluid
• Therapeutic relief of symptoms associated with fluid accumulation

Contraindications

While pericardiocentesis is generally safe, there are contraindications, such as:

• Uncorrected coagulopathy
• Small, asymptomatic effusions
• Loculated effusions that are not accessible

Procedure

The procedure is typically performed under ultrasound or echocardiography guidance to increase safety and accuracy. The steps include:

1. Preparation: The patient is positioned supine with the head elevated. The skin is cleaned and draped. 2. Local Anesthesia: Local anesthetic is administered to the skin and deeper tissues. 3. Needle Insertion: A needle is inserted into the pericardial space, usually via the subxiphoid approach. 4. Fluid Aspiration: Fluid is aspirated and collected for analysis. 5. Catheter Placement: A catheter may be placed for continuous drainage if necessary.

Complications

Potential complications of pericardiocentesis include:

• Pneumothorax
• Cardiac puncture
• Arrhythmias
• Infection

Recovery and Follow-up

After the procedure, patients are monitored for signs of complications. Follow-up may include:

• Repeat echocardiogram to assess fluid reaccumulation
• Monitoring of vital signs and cardiac function

See Also

• Pericarditis
• Pericardial effusion
• Cardiac tamponade

External Links

• [American Heart Association](https://www.heart.org)
• [Mayo Clinic](https://www.mayoclinic.org)

Pericardiocentesis

• 
  Pericardiocentesis
• 
  Pericardiocentesis locations