Pericardiocentesis

What is a pericardiocentesis?

The pericardium is a sac that contains the heart and the 'roots' of the main blood vessels of the heart. It separates and protects the heart from the other organs in the body and encloses the 'pericardial cavity' where the heart sits. This cavity naturally contains a small amount of 'pericardial fluid' (normally 15-50ml).

Where there is a buildup of pericardial fluid significantly above these levels - referred to as 'pericardial effusion' - the pressure of this fluid on the heart can affect the functioning of the heart. If this occurs it is referred to as 'cardiac tamponade' and is potentially a life threatening condition.

Pericardiocentesis is the procedure to remove excess pericardial fluid from around the heart.

What are the symptoms of a pericardial effusion?

Pericardial effusion often has no symptoms or sometimes can be accompanied by a feeling of chest discomfort, breathlessness or lack of energy.

What causes a pericardial effusion?

Many things can cause a buildup of fluid in the pericardium. Common causes include...

  • Pericarditis - irritation and inflammation of the pericardium
  • Some infections including tuberculosis and some viral infections
  • A previous heart attack
  • Cancer spreading to the pericardium
  • Heart surgery
  • Kidney failure
  • Inflammatory conditions such as rheumatoid arthiritis and lupus
  • Hyperthyroidism

How is a pericardial effusion diagnosed?

The most common and accurate tool for diagnosis of the condition is echocardiography.

What is involved in the procedure?

The excess fluid is removed from within the pericardium with a very thin needle while using echocardiography and/or x-ray imaging. It is normally conducted as a minimally invasive procedure although occasionally conventional surgery may be required.

It may be necessary to leave a catheter (a thin tube) in place for a few days to continue to drain fluid if more fluid is being produced. The fluid is normally sent away for analysis to determine the cause of the buildup of fluid.