Pericardiocentesis
Alternate Names : Percutaneous Pericardiocentesis, Pericardial Tap
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How is the Test Performed?
In the past this procedure was performed in a cardiac catheterization laboratory, but now it is usually performed in the procedure room of an intensive care unit, or even at the bedside.
An IV line is inserted, to be used if fluids or medications need to be given. Medication may be given to prevent vasovagal reflex resulting in bradycardia (a slowing of the heartbeat) and hypotension (fall in blood pressure).
The insertion site just below the sternum (breastbone) will be cleansed and a local anesthetic will be given. A pericardiocentesis needle will then be introduced and guided into the pericardial sac. Electrocardiographic (ECG) leads may be attached by a clip to the needle to help with proper needle positioning. An echocardiogram is more frequently used to help in positioning the needle and monitoring the drainage procedure.
Once the needle reached the pericardial sac, a guide wire is passed. The needle is removed and and replaced with a catheter. The fluid is withdrawn through this catheter and put into containers. Usually this pericardial catheter is left in place for continuous draining for several hours.
Surgical pericardiocentesis may be necessary in difficult cases. In this procedure the fluid is drained through a more invasive procedure that may require additional anesthesia.
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