Pericardiocentesis or cardioparacentesis is the drainage of fluid from the pericardial cavity. It is indicated for:
- treatment of pericardial effusion; often used in the emergency situation for relief of pericardial tamponade
- diagnosis of cause of effusion
There are two approaches to the pericardial sac:
- infrasternal angle:
- pass hollow needle between left side of xiphisternum and costal cartilage
- direct needle superiorly, posteriorly and slightly laterally
- fifth or sixth intercostal space:
- left interspace is traversed by needle or dissected out close to the sternum
- care must be taken to identify and avoid the internal thoracic vessels
- more suitable site for long-term drainage of an effusion by passage of a tube
The patient should be monitored by ECG; when the needle impinges upon the pericardium, abnormal electrical activity may be witnessed.
Note that paracentesis is also used to describe the drainage of ascites.
Last reviewed 01/2018