ABSTRACT
Pericardiocentesis is the transcutaneous drainage of fluid from the pericardial space. Pericardiocentesis is performed for both diagnostic and therapeutic indications. Elective pericardiocentesis may be necessary if bacterial infection is suspected or the source of the pericardial effusion is unknown. Therapeutic pericardiocentesis for pericardial tamponade may be emergent and life-saving. The pericardium consists of two layers, the visceral pericardium that is adherent to the epicardium and the parietal pericardium that normally is about 1-2 mm thick. Chest pain, dyspnea at rest or with exertion, pleuritic pain, or palpitations may be associated with pericardial effusion, but there are no specific symptoms. The most common indication for pericardiocentesis is to discern the etiology of a chronic effusion. In elective pericardiocentesis, an echocardiogram at the bedside is necessary for quantitating and localizing the effusion, and determining needle placement. Dysrhythmias can occur during pericardiocentesis, and may be due to the irritation from the needle or catheter on the epicardium.
