Pericardiocentesis is the insertion of a needle or catheter into the pericardial sac
. The usual approach is to pass the needle through the chest wall and into the pericardium. The procedure is often performed to evaluate and/or drain pericardial effusion
Pericardiocentesis may performed to relieve cardiac tamponade
. Removing the fluid relieves pressure on the heart and allows it to fill and pump blood more effectively.What Does Pericardiocentesis Reveal?
Pericardiocentesis is performed to treat or help diagnose disease. The fluid that is removed may be submitted for laboratory analysis.
In addition, pericardiocentesis may be performed prior to taking radiographs (X-rays) of the heart to enhance the visualization of the heart. In addition, the pericardial sac may be injected with radiographic contrast material for further diagnostic clarification.How is Pericardiocentesis Performed?
A rectangular area on the side of the chest is shaved and sterilized. The shaved area typically extends from the sternum to mid chest, and from the 2nd to the 8th ribs. The patient should be attached to an electrocardiograph (EKG) to monitor heart rate and rhythm throughout the procedure.
The procedure is most often performed on the right side of the chest, so that the needle passes through a natural gap between the lungs. This approach also helps avoid major coronary vessels that are located primary on the left side of the heart.
A needle or intravenous catheter is inserted until it reaches the pericardial sac. The catheter or needle is threaded into the sac and the fluid is aspirated (suctioned) into a syringe. The fluid is then transferred to test tubes for later laboratory analysis.
If an ultrasound is available, it is helpful to guide the catheter or needle more accurately and more safely into the pericardial sac.Is Sedation or Anesthesia Required?
Local anesthetic applied to the skin and chest wall where the needle/catheter will penetrate is usually all that is required. If necessary, a mild sedative may be given.Is Pericardiocentesis Painful?
This procedure is performed with a local anesthetic that dulls the pain associated with passage of the needle or catheter through the skin and muscles of the chest wall. Most pets tolerate the procedure very well.