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 into the pericardium. The procedure is often usually performed to evaluate or remove 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 either to treat or to help diagnose disease. The fluid removed may be submitted to a laboratory for analysis.
In addition, pericardiocentesis may be performed prior to taking radiographs (X-rays) of the heart when proper visualization of the heart is impaired by accumulations of pericardial fluid. After the fluid is removed, radiographic contrast material, used to enhance the visualization of the heart and the pericardial sac, may be injected into the pericardial sac.How is Pericardiocentesis Performed?
A rectangular area of skin over the chest wall is shaved and sterilized. The shaved area usually extends from the sternum to mid chest, and from the 2nd to the 8th ribs. The patient is usually attached to an electrocardiograph (EKG) during the procedure to monitor heart rate and rhythm throughout the procedure.
The procedure is most often performed on the right side of the chest, so the needle can pass 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 fluid aspirated (suctioned) into a syringe. The fluid is then transferred to tubes for later laboratory analysis.
If an ultrasound is available, it can be used to help guide the catheter into the pericardial sac more accurately and safely.Is Sedation or Anesthesia Required?
A local anesthetic is usually injected into the skin and muscle of the chest wall where needle penetration will occur. If needed, a mild sedative may be given.Is Pericardiocentesis Painful?
The procedure is performed with local anesthetic that dulls the pain associated with passage of the needle through the skin and muscles of the chest wall. With local anesthetic in place, most dogs tolerate pericardiocentesis very well.