Lexicomp and UpToDate Patient Handouts: Pericardiocentesis

Patient Education

Pericardiocentesis
Why is this procedure done?
The heart sits in a thin sac of tissue called the pericardium. Fluid or blood may build up in this sac and push
against the heart. This is pericardial effusion. The pressure on the heart from this extra fluid may cause blood
flow from the heart to be less. This is cardiac tamponade. The fluid build up in the sac may also prevent the
heart from beating and can cause cardiac arrest.
A pericardiocentesis is done to ease pressure and drain extra fluid from around the heart. The fluid that is
removed may help doctors learn what caused the fluid to build up. This may be done as a scheduled or
emergency procedure.

What will the results be?

The extra fluid will be removed.

The heart can return to normal function.

The doctor may find the cause of the extra fluid.

What happens before the procedure?

During an emergency, there are no preparations needed.

Talk to your doctor about:

All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs,
and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with
you.

Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause
bleeding. Some of these are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins
and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop
these drugs as well. Talk to your doctor about them.

When you need to stop eating and drinking before the procedure.

Your doctor may order:

 Blood tests

Chest x-ray

Electrocardiogram (ECG)

Echocardiogram

CT scan or MRI

You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive
you home.

Based on the reason for the fluid around your heart, you may need to spend the night in the hospital so
that the staff can watch and monitor your condition.

What happens during the procedure?

If you are in an ICU, this can be done at the bedside in an emergency.

Once you are in the procedure room, the staff will put an IV in your arm to give you fluids and drugs.
The doctor will give you a drug to calm and relax you.

Your heart and oxygen in your blood will be watched.

The doctor will clean the area below your breastbone and numb it. With the help of other tools like
ultrasound and fluoroscopy, the doctor will put a needle through your chest into the sac around your
heart and remove some of the extra fluid.

The doctor may also put a rubber tube called a catheter over the needle and then remove the needle.
The fluid will drain through the catheter into a container. The doctor will remove the catheter once
enough fluid has drained out. Pressure will be held on the site and a bandage will be placed over the
area.

The procedure takes 20 to 60 minutes.

In some cases, the catheter is left in place to drain the extra fluid over a few hours to days.

What happens after the procedure?

The staff will carefully monitor your blood pressure, heart rate, and heart function after the procedure.

The doctor will order a chest x-ray to look at your heart and lungs.

Your doctor will send a sample of the fluid to the lab for testing. Ask your doctor when you can get the
results.

Your doctor will tell you when you may go home.

What care is needed at home?

Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not
understand what the doctor says. This way you will know what you need to do.

Follow your doctor's orders.

Ask your doctor when you can go back to your normal activities.

What follow-up care is needed?

Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
Together you can make a plan for more care.

What problems could happen?

Infection

Bleeding

Low blood pressure

Heart is not working as well

Heartbeat not normal

Collapsed lung

Fluid builds up around the lungs. This is pleural effusion.

Fluid around the heart can build up again.

When do I need to call the doctor?

Signs of infection. These include a fever of 100.4°F (38°C) or higher, chills, wound that will not heal.

Trouble breathing

Very bad pain at the site

Lots of bleeding from the site

Feeling faint

Sudden slow or fast heartbeat

Last Reviewed Date

2018-10-31

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This information is not specific medical advice and does not replace information you receive from your health
care provider. This is only a brief summary of general information. It does NOT include all information about
conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style
choices that may apply to you. You must talk with your health care provider for complete information about
your health and treatment options. This information should not be used to decide whether or not to accept
your health care provider’s advice, instructions or recommendations. Only your health care provider has the
knowledge and training to provide advice that is right for you.

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