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Pericardiocentesis
Synonym(s): Cardiac tamponade aspiration
Introduction
- There is a potential space between the myocardium and the pericardium (the pericardial sac).
- This space may become distended with fluid.
- Pressure within the pericardial sac compromises cardiac function (cardiac tamponade) - particularly by causing collapse of the thinner-walled right ventricle.
- Cardiac tamponade → acute congestive heart failure Congestive heart failure.
Uses
- Drainage of pericardial fluid.
- Septic pericarditis (ie secondary to traumatic Reticulitis Reticulitis/ wire/ nail etc). A penetrating foreign body, originating from the reticulum, is almost always the cause of pericarditis in cattle.
- Idiopathic pericardial effusion (hemorrhage). Cardiac tamponade
- Pericardial/heart base tumors → transudation or hemorrhage .
Advantages
- Life-saving.
- Minimally invasive procedure when correctly performed.
- Produces rapid benefit to patient.
Disadvantages
- Risk of lacerating myocardium or coronary arteries.
- May be unable to drain all fluid from pericardial sac.
- Risk of recurrence of fluid accumulation.
Technical problems
- Some experience of the procedure and moderate dexterity is required.
Alternative techniques
- Pericardectomy- but requires thoracotomy, and so is unlikely to be an option in cattle practice, but can be performed standing.
- Not appropriate in acute cases as cardiac function may be insufficient to tolerate general anesthesia Anesthetizing cattle.
Time required
Preparation
- Preferably ultrasonography should be used to confirm the presence of pericardial fluid.
- Place an intravenous catheter to allow drug and fluid administration if necessary Intravenous catheter placement and care.
Procedure
- 10-30 minutes (depending on quantity of fluid and ease with which it can be drained).
Decision taking
Criteria for choosing test
- If cardiac function is compromised by presence of fluid then drainage is indicated.
- Must confirm fluid presence.
Risk assessment
- The small risk associated with procedure is outweighed by the likelihood of fatality if condition is untreated.
Requirements
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Preparation
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Technique
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Aftercare
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Outcomes
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Further Reading
Publications
Refereed Papers
- Recent references from PubMed and VetMedResource.
- Athar H, Parrah J D, Moulvi B A, Singh M & Dedmari F H (2012) Pericarditis in bovines - a review. Intern J Advan Vet Sci Tech 1 (1), 19-27.
Other sources of information
- Tobias A H (2010) Pericardial Diseases. In: Textbook of Veterinary Internal Medicine. 7th edn. Eds: Saunders Elsevier. pp 1342-1352.
- Kienle R D & Kittleson M D (2005) Pericardial Disease and Cardiac Neoplasia. In: Small Animal Cardiovascular Medicine. Mosby, USA.
- Sisson D & Thomas W (1999) Pericardial Disease and Cardiac Tumours. In: Textbook of Canine and Feline Cardiology. 2nd edn. W B Saunders, USA. pp 679-701.