Pericardial Fluid Analysis
A needle is used to aspirate fluid from the pericardial sac, which surrounds the heart. The fluid sample is sent for laboratory analysis to identify the cause of pericardial effusion (excess fluid around the heart). Pericardiocentesis may also be performed as an emergency therapeutic measure to relieve increased pressure on the heart.
Purpose of the Pericardiocentesis
- To determine the cause of pericardial effusion and help select an appropriate treatment
- To determine what is causing fluid to build up
- Used as a treatment to relieve excessive pressure on the heart, known as cardiac tamponade, which can interfere with the contractions of the heart.
Who Performs Pericardiocentesis
- A physician
Special Concerns about Pericardiocentesis
- Tell your doctor if you have a bleeding disorder; if so, pericardiocentesis should not be done.
- This procedure must be performed in a cardiac catheterization laboratory, an operating room, or an emergency room.
Before the Pericardiocentesis
- If this is an elective procedure, restrict your fluid and food intake for 6 hours before the test.
- Your doctor may ask if you are taking any antimicrobial drugs, such as antibiotics.
What You Experience
- After removing your shirt, you will lie down on a table. You must remain still during the procedure.
- An intravenous (IV) line will be inserted into a vein in your arm to administer fluid, medications, or a sedative, if necessary.
- ECG leads may be used to monitor your heart rate and rhythm during the procedure.
- The skin at the site of needle insertion (just below and to the left of the sternum) is swabbed with an antiseptic solution, and then a local anesthetic is administered to numb the area.
- The aspiration needle is inserted through the chest wall into the pericardial sac; you will feel pressure during insertion, but there will be no other discomfort.
- You may be asked to hold your breath briefly to make it easier for the doctor to accurately place the needle.
- Once the needle is inserted, a clamp is attached to hold it in place, and fluid is withdrawn through the needle into multiple specimen containers.
- The procedure takes 10 to 20 minutes.
- A pericardial catheter may be left in place to drain continuously for 1 to 3 days.
Risks and Complications of Pericardiocentesis
- Potentially dangerous complications of this procedure include unintentional laceration of a coronary artery or the heart muscle; a life-threatening arrhythmia called ventricular fibrillation; cardiac arrest; pleural (lung) infection; and accidental puncture of the lung, liver, or stomach. Emergency equipment is available if such complications arise.
- The risk of complications is reduced if echocardiography or fluoroscopy is used to visualize the heart and guide needle insertion.
After the Pericardiocentesis
- When the test is completed, the needle is withdrawn.
- Pressure is applied to the needle insertion site with sterile gauze pads for 3 to 5 minutes. A bandage is then applied.
- Your blood pressure and vital signs will be monitored periodically for a few hours after the procedure.
- The specimen containers may be sent to several different laboratories for examination. The fluid will be analyzed for the presence of blood, bacteria, malignant cells, and other components.
- Your doctor will diagnose the cause of the pericardial effusion based on results from these laboratory tests. Possible causes include acute heart attack, pericarditis, tuberculosis, cancer, rheumatoid disease, systemic lupus erythematosus, hypothyroidism, and infection.
- Appropriate treatment will be initiated, depending on the problem.
The Johns Hopkins Consumer Guide to Medical Tests
Simeon Margolis, M.D., Ph.D., Medical Editor
Updated by Remedy Health Media