eMedicine Specialties > Cardiology > Invasive Diagnostic, Interventional, and Surgical Procedures

Pericardiocentesis: Follow-up

Author: Ali A Sovari, MD, Research Fellow, Division of Cardiology, David Geffen School of Medicine, University of California, Los Angeles (UCLA)
Coauthor(s): Ravi H Dave, MD, Associate Professor of Medicine, University of California at Los Angeles David Geffen School of Medicine; Abraham G Kocheril, MD, FACC, FACP, Professor of Medicine, Director of Clinical Electrophysiology, University of Illinois at Chicago
Contributor Information and Disclosures

Updated: Jan 28, 2009

Follow-up

Further Inpatient Care

Assess for the following in the postoperative period:  

  • Patency of the pericardial catheter: The catheter can be connected to the suction continuously or urokinase can be used in the catheter with intermittent opening of the catheter for drainage.
  • Hypotension
  • Ventricular puncture
  • Cardiac arrest
  • Pulseless electrical activity
  • Pneumothorax
  • Liver laceration
  • Clinical correlation with previous physical finding

Complications

  • Laceration of coronary artery
  • Laceration of coronary vein
  • Pericardial tamponade
  • Acute left ventricular failure with pulmonary edema
  • Puncture or laceration of any cardiac chamber
  • Bleeding
  • Ventricular ectopic beats
  • Atrial ectopic beats
  • Arrhythmias
  • Hypotension
  • Pneumothorax
  • Pulmonary edema

Prognosis

With the advent of 2-dimensional echocardiography, the morbidity and mortality rate have been significantly reduced. Blind pericardiocentesis, which has significantly higher risk of complications compared with echocardiographic-guided or fluoroscopic-guided procedures, should be left for emergency situations in patients with cardiac tamponade and significant hemodynamic instability. A high mortality has been shown in patients undergoing pericardiocentesis when presenting with pulmonary arterial hypertension complicated by pericardial effusion.10

Miscellaneous

Medicolegal Pitfalls

Contraindications to pericardiocentesis include the following:

  • Myocardial rupture
  • Aortic dissection
  • Skin infection at site
  • Severe bleeding disorder

 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors Kishorkumar Desai, MD, Shivkumar H Jha, MD, Jatin Dave, MD, MPH, to the development and writing of this article.



More on Pericardiocentesis

Overview: Pericardiocentesis
Differential Diagnoses & Workup: Pericardiocentesis
Treatment & Medication: Pericardiocentesis
Follow-up: Pericardiocentesis
Multimedia: Pericardiocentesis
References
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References

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Further Reading

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Keywords

pericardiocentesis, percutaneous pericardiocentesis, echo-guided pericardiocentesis, pericardial tap, pericardial disease, heart disease, cardiac disease, cardiac procedure, pericardial effusion, pericardial fluid, hemopericardium, chylopericardium, pneumopericardium, tension pneumopericardium

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Contributor Information and Disclosures

Author

Ali A Sovari, MD, Research Fellow, Division of Cardiology, David Geffen School of Medicine, University of California, Los Angeles (UCLA)
Ali A Sovari, MD is a member of the following medical societies: American College of Physicians, American Heart Association, and American Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Ravi H Dave, MD, Associate Professor of Medicine, University of California at Los Angeles David Geffen School of Medicine
Disclosure: Nothing to disclose.

Abraham G Kocheril, MD, FACC, FACP, Professor of Medicine, Director of Clinical Electrophysiology, University of Illinois at Chicago
Abraham G Kocheril, MD, FACC, FACP is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Heart Association, American Medical Association, Cardiac Electrophysiology Society, Central Society for Clinical Research, Heart Failure Society of America, Heart Rhythm Society, and Illinois State Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Gary E Sander, MD, PhD, Professor, Department of Internal Medicine, Division of Cardiology, Tulane University Health Sciences Center
Gary E Sander, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American College of Cardiology, American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, American Heart Association, American Society of Hypertension, Heart Failure Society of America, Louisiana State Medical Society, and Southern Society for Clinical Investigation
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Ronald J Oudiz, MD, FACP, FACC, Associate Professor of Medicine, Division of Cardiology, The David Geffen School of Medicine at UCLA; Director, Liu Center for Pulmonary Hypertension, LA Biomedical Research Institute at Harbor-UCLA Medical Center
Ronald J Oudiz, MD, FACP, FACC is a member of the following medical societies: American College of Cardiology, American College of Physicians, and American Heart Association
Disclosure: Actelion Grant/research funds Clinical Trials + honoraria; Encysive Grant/research funds Clinical Trials + honoraria; Gilead Grant/research funds Clinical Trials + honoraria; Pfizer Grant/research funds Clinical Trials + honoraria; United Therapeutics Grant/research funds Clinical Trials + honoraria; Lilly Grant/research funds Clinical Trials + honoraria; LungRx  Clinical Trials + honoraria

CME Editor

Amer Suleman, MD, Consultant in Electrophysiology and Cardiovascular Medicine, Department of Internal Medicine, Division of Cardiology, Medical City Dallas Hospital
Amer Suleman, MD is a member of the following medical societies: American College of Physicians, American Heart Association, American Institute of Stress, American Society of Hypertension, Federation of American Societies for Experimental Biology, Royal Society of Medicine, and Society of Cardiac Angiography and Interventions
Disclosure: Nothing to disclose.

Chief Editor

Karlheinz Peter, MD, PhD, Professor of Medicine, Monash University; Head of Centre of Thrombosis and Myocardial Infarction, Head of Division of Atherothrombosis and Vascular Biology, Associate Director, Baker Heart Research Institute; Interventional Cardiologist, The Alfred Hospital, Australia
Karlheinz Peter, MD, PhD is a member of the following medical societies: American Heart Association, Cardiac Society of Australia and New Zealand, and German Cardiac Society
Disclosure: Nothing to disclose.

 
 
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