Pericardiocentesis is necessary when fluid has accumulated in the pericardium, or the sac around the heart. This fibrous sac around the heart is made up of two thin layers with fluid between them to reduce friction when the heart beats. When excess fluid builds up between the two layers, pericardial effusion occurs and can affect the heart’s function. A doctor may perform a cardiocentesis to drain the fluid and prevent it from building up in the future.

Fluid build-up can result from numerous medical conditions, causing symptoms such as chest pain and shortness of breath. Patients with cancer or immune system diseases may experience fluid around the heart, while the condition can also be caused by a drug reaction, injury, or heart infection. Sometimes fluid builds up around the heart for no clear reason.

Less invasive than surgery, pericardiocentesis involves the use of x-ray imaging or echocardiogram to help the doctor guide the insertion of a long needle through the chest wall and into the tissue around the heart. Once the needle is inside the pericardium, the doctor inserts a catheter that drains the excess fluid.

Depending on how much fluid must be drained, the doctor may remove the catheter immediately following the procedure, or it may remain for several hours to ensure complete drainage. In some cases, the doctor may opt to surgically drain the fluid, typically in patients who experience chronic buildup or inflammation.

The patient remains awake as an IV is placed in the hand or arm. They then receive medication to make them sleepy. An echocardiogram allows the doctor to see the anatomy of the heart and the surrounding fluid, helping them determine the optimal placement for the needle.

After administering local anesthetic at the injection site, the doctor inserts the needle into the skin below the breastbone. Pain medicine is usually optional, and the patient typically experiences a sensation of pressure as the needle enters.

Upon waking after the pericardiocentesis, a patient may feel disoriented or groggy. If the doctor has already removed the catheter, the site should be clean and covered with a bandage. If a catheter remains in place, a doctor or nurse will ensure it is not blocked before removal.

The doctor may order an electrocardiogram to evaluate how much (if any) fluid remains, and the removed fluid may be sent to a laboratory for testing. Additionally, a chest x-ray may be done to ensure the procedure did not cause any damage. Most patients remain in the hospital for several days following the procedure.

After leaving the hospital, patients should refrain from heavy physical activity until cleared by their doctors. Patients also need to follow instructions for follow-up care, including wound care and medication. Most people experience immediate symptom relief after pericardiocentesis.

The innovative Physiological Cardiac Assist Device (PCAD), developed by AOK Innovations, Inc., streamlines and simplifies the pericardiocentesis procedure. The disposable device eliminates the need to open multiple sterile kits and allows physicians to drain pericardial fluid rapidly and safely with no additional surgical instruments.

The all-in-one device includes a self-contained syringe designed for both pericardiocentesis and pericardial drain placement. Ideal for settings such as the emergency room, as well as cardiology and radiology labs, it can be deployed with echo or ultrasound guidance.