Pericardiocentesis, also called a pericardial tap, is an invasive procedure that involves using a needle and catheter to remove fluid (called a pericardial effusion) from the sac around the heart (the pericardium). The fluid may then be sent to a laboratory for tests to look for signs of infection or cancer.

Occasionally, pericardiocentesis is performed on an emergency basis to treat a condition called cardiac tamponade. This condition is a life-threatening, rapid buildup of fluid around the heart that puts pressure on the heart muscle, weakening its pumping ability.

Why Is a Pericardiocentesis Performed?

Your doctor uses pericardiocentesis to:

  • Determine cause of fluid around the heart, such as infection or cancer.
  • Relieve symptoms, such as shortness of breath, caused by having fluid around the heart.

To Prepare for a Pericardiocentesis:

  • You can wear whatever you like to the hospital for a pericardiocentesis. You will wear a hospital gown during the procedure.
  • Leave all valuables at home.
  • Your doctor or nurse will give you specific instructions about what you can and cannot eat or drink before the procedure.
  • Ask your doctor what medications should be taken on the day of your test.
  • If you have diabetes, ask your physician how to adjust your medications the day of your test.
  • Tell your doctor and/or nurses if you are allergic to anything.
  • Bring all medications and any previous test results.
  • You will need a companion to bring you home.

What To Expect During a Pericardiocentesis:

A pericardiocentesis takes about 20 to 60 minutes to perform.

  • You will be given a hospital gown to wear.

  • The room will be cool and dimly lit. You will lie on a special table in the cardiac cath lab.

  • You will be given a mild sedative to relax you, but you will be awake and conscious during the entire procedure.

  • An IV (intravenous) line is inserted in your hand or arm in case fluids or medications are needed.

  • The doctor will use a local anesthetic to numb an area on your chest. A needle will be inserted and then a catheter (a thin plastic tube) into the pericardial sac around your heart. The doctor may use an x-ray or echocardiography machine to make sure the catheter is positioned correctly. The doctor will drain the fluid that has collected around your heart.

  • When the fluid has been removed, the catheter will be removed.

After the Pericardiocentesis:

Your doctor will monitor you for several hours after a pericardiocentesis. If the procedure isn't successful, more invasive treatments may be needed to drain fluid from around the heart (pericardiotomy) or to strip the pericardium away to relieve tamponade (pericardiectomy).

What Are the Risks of Pericardiocentesis?

Pericardiocentesis is usually fairly safe, especially when imaging is used to guide the needle. But there is a risk that the procedure may:

  • Induce an irregular heart rhythm
  • Cause cardiac arrest
  • Cause a heart attack
  • Puncture the heart


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