Pericardial Drainage

Pericardiocentesis

How It Is Done

A diagnostic pericardial drainage is usually done in a cardiac procedure room. If the drainage is being done to relieve pressure on the heart, it may be done in an emergency room or in your hospital room. This procedure is normally performed by a cardiologist, a cardiovascular surgeon, or an emergency medicine doctor.

During the test, your heart is monitored using electrocardiography. You will have an intravenous (IV) line for any medicine that may need to be given during the test. You may be given a mild sedative to help you relax.

In nonemergency situations, you will lean back at an angle on the bed or table. Your chest will be shaved (if necessary), cleaned with an antiseptic solution, and covered with sterile drapes.

A local anesthetic will be injected to numb the skin and deeper tissues, and then a long thin needle will be carefully inserted just below your breastbone. In some cases the needle is inserted between your ribs on the left side, over your heart. The needle is then slowly advanced through the pericardial sac into the pericardial space. Fluid is removed and sent to the laboratory. At different times during the procedure, you may be asked to hold your breath. You must remain very still throughout the procedure. An electrocardiography machine may be attached by a wire to the needle to help the doctor guide the needle into the pericardial space. In some hospitals an echocardiogram is done at the same time to help the doctor follow the location of the needle during the procedure, or an X-ray camera may be used to guide the procedure.

After some or all of the fluid is removed, the needle is withdrawn and pressure is applied to the injection site for several minutes to stop any bleeding. Fluid also may be drained through a thin catheter over a period of hours.

This procedure takes 10 to 20 minutes. After the test, you will have a chest X-ray to check for possible puncture and collapse of your left lung. You will be closely observed for several hours, with frequent checks of your blood pressure, heart rate, and breathing rate.

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Author:	Sydney Youngerman-Cole, RN, BSN, RNC	Last Updated: July 24, 2006
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine George Philippides, MD - Cardiology
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