Pericardial Drainage

A diagnostic pericardial drainage is usually done in a cardiac procedure room. If the drainage is being done to relieve pressure on the heart, it may be done in an emergency room or in your hospital room. This procedure is normally performed by a Reference cardiologist Opens New Window, a Reference cardiovascular surgeon Opens New Window, or an Reference emergency medicine doctor Opens New Window.

During the test, your heart is monitored using an Reference electrocardiogram (EKG, ECG) Opens New Window. You will have an Reference intravenous (IV) Opens New Window line for any medicine that may need to be given during the test. You may be given a mild Reference sedative Opens New Window to help you relax.

In nonemergency situations, you will lean back at an angle on the bed or table. Your chest will be shaved (if necessary), cleaned with an antiseptic solution, and covered with sterile drapes.

A Reference local anesthetic Opens New Window will be injected to numb the skin and deeper tissues, and then a long thin needle will be carefully inserted just below your breastbone. In some cases the needle is inserted between your ribs on the left side, over your heart. The needle is then slowly advanced through the pericardial sac into the pericardial space. Your doctor may use an Reference echocardiogram Opens New Window or EKG to help guide the needle. Or an X-ray camera may be used to guide the procedure.

The doctor then guides a catheter, which is a thin plastic tube, along the needle into the pericardial space. The fluid drains out through the catheter. Some fluid may be saved and sent to a laboratory for tests. At different times during the procedure, you may be asked to hold your breath. You must remain very still throughout the procedure.

This procedure takes 10 to 20 minutes. Sometimes your doctor will let the fluid drain through the catheter for a few hours.

After some or all of the fluid is drained, the catheter is removed, and pressure is applied to the injection site for several minutes to stop any bleeding.

After the test, you will have a chest X-ray to check for possible puncture and collapse of your left lung. You will be closely observed for several hours, with frequent checks of your blood pressure, heart rate, and breathing rate.

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