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What is pericardiocentesis and pericardial drainage?
Pericardiocentesis, also known as pericardial drainage, is a medical procedure to drain a build-up of fluid that has collected around your heart (pericardial effusion). This is a potentially life-threatening condition that prevents the heart from functioning normally. During pericardiocentesis, a needle is inserted into the pouch that surrounds the heart (pericardium) and the excess fluid is drained away. This treatment is less invasive than open surgery, and is generally recommended when the heart can no longer function effectively. Fluid build-up around the heart can either happen suddenly, or gradually over time. Pericardiocentesis is often used as an emergency procedure to relieve pressure on the heart caused by a sudden build-up of fluid. This condition is known as cardiac tamponade, and it requires immediate medical attention.
What does it do?
Pericardiocentesis is a medical treatment that reduces pressure by removing the excess fluid that has collected around the heart. It is often used as a life-saving emergency procedure for cardiac tamponade, a dangerous condition that can potentially stop your heart. A needle is inserted into the heart sac (pericardium) and a catheter is used to drain away the fluid.
How does it work?
A healthy heart sits in a pouch made of two thin layers (pericardium). There is a small amount of fluid in between the layers that allows the heart to move around without friction. If too much fluid builds up in the pouch, this can restrict how the heart functions as it no longer has enough room to expand and fill up with blood. Pericardiocentesis uses a small needle and catheter to directly drain away the excess fluid, or a special device that drains slowly over time to prevent any more fluid building back up.
Why is it performed?
There are many conditions that may cause fluid to build up around the heart (pericardial effusion) that have symptoms such as shortness of breath and chest pain. These conditions include cancer, infection, inflammation, injury and organ failure. Pericardiocentesis is a minimally invasive procedure to drain away any excess fluid, reduce pressure on the heart, and diagnose the cause of the condition. In severe cases, the fluid may be surgically drained.
Procedure
Pericardiocentesis is generally performed under local anaesthetic, although this will depend on individual patients and whether or not the procedure is required as an emergency.
- An echocardiogram is used to examine the fluid around your heart and determine the best place to insert the needle
- A needle is carefully inserted into the chest and guided to the heart sac using special imaging techniques
- A catheter replaces the needle and remains in place until all the excess fluid has drained
- The fluid may be tested to determine the cause
Recovery
After pericardiocentesis, your doctor may recommend further imaging tests, such as an echocardiogram, to ensure the fluid has drained. The length of hospital stay will depend upon the reason for the pericardiocentesis procedure. Your doctor will talk to you about what your personal recovery will look like, and when you can expect to resume your daily activities. Most patients notice an immediate improvement in symptoms once the fluid has been drained.
What's next?
If you have been experiencing heart-related symptoms, book an appointment with our cardiac services specialist today.
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