ABSTRACT
COMPLICATIONS One complication of pericardiocentesis is laceration of cardiac or noncardiac structures. Because the right ventricle and vena cava lie anterior they are the most common cardiac structures to be inadvertently punctured; however, coronary arteries, coronary veins, and the internal thoracic artery may also be lacerated. Serous colored fluid that quickly turns bloody may be an indication of laceration of a cardiac structure. While rare, noncardiac structures including the liver, spleen, and stomach can be lacerated. The easiest way to avoid inadvertent puncture of these structures is to carefully select the path of the pericardiocentesis needle. Inject iodinated contrast or saline with x-ray or echocardiographic imaging to demonstrate the location of a puncture (13).
