Pericardiocentesis

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Pericardiocentesis, also known as a cardiac tap, is a procedure performed to remove excess fluid from the pericardial sac – the thin, two-layered, fluid-filled sac surrounding the heart. Excessive fluid accumulation, or pericardial effusion, can compress the heart and affect its ability to pump blood effectively, a condition known as cardiac tamponade.

The procedure is typically performed in a hospital under local anesthesia, although sedation may be used depending on the patient’s condition. The patient is placed on their back and connected to an electrocardiogram (ECG) machine to monitor heart activity throughout the procedure.

Under sterile conditions, the doctor inserts a needle into the chest wall, usually at the left or right of the sternum or below the xiphoid process. Using echocardiography or fluoroscopy as a guide, the needle is carefully advanced into the pericardial sac. A syringe is then attached to the needle to draw out the excess fluid.

Once the fluid is removed, a catheter may be left in place if continuous drainage is necessary. The needle insertion site is then bandaged. The removed fluid is often sent to a laboratory for analysis to determine the cause of the effusion.

The procedure usually takes about 20-60 minutes. After the procedure, the patient is closely monitored for several hours to ensure there are no complications. 

Pericardiocentesis can provide immediate relief from symptoms associated with pericardial effusion such as shortness of breath, chest pain, or discomfort. This procedure also provides diagnostic information that can help determine the underlying cause of the effusion. As with all medical procedures, pericardiocentesis carries some risks, such as infection or puncture of the heart or lung, which should be discussed with the healthcare provider.