ISSN 2398-2985      

Pericardiocentesis

Jreptile

Synonym(s): Pericardial drainage, Pericardial tap


Introduction

  • Presence of pericardial effusion:
    • Particularly if cardiac tamponade and cardiovascular and respiratory compromise are present.
    • Secondary to cardiac disease: reported in a Bearded dragon Bearded dragons with atherosclerosis of the major arteries at the heart base.
    • Secondary to neoplasia: endocardial fibrosarcoma reported in a snake.
  • Trauma:
    • Uncommonly reported in exotic animals.
    • Can be secondary to cardiac blood sampling in snakes.
  • Sampling of pericardial fluid for cytology Cytology: fluid sampling and/or microbial culture and sensitivity in pericardial disease: pericarditis (bacterial, fungal, inflammatory, migrating foreign body).

Uses

Advantages

  • Allows rapid reduction of increased pericardial pressures associated with pericardial effusion:
    • Acute management of clinical signs associated with cardiac tamponade and/or respiratory compromise.
  • Relatively non-invasive and low risk with sufficient expertise.

Disadvantages

  • Risk of cardiac puncture or pulmonary laceration.
  • Chemical restraint (sedation or general anesthesia Anesthesia overview) is usually required:
    • Increased anesthetic risk as majority of exotic animals requiring pericardiocentesis present with cardiovascular and/or respiratory compromise.
  • Risk of further hemorrhage in cases of hemorrhagic pericardial effusion due to coagulopathy or cardiac trauma.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Varies depending on etiology.
  • Prognosis can be guarded to poor if underlying cardiac disease or neoplasia identified.

Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Paillusseau C, Gandar F, Schilliger L et al (2019) Atrioventricular stenosis and insufficiency associated with chronic endocarditis in a jungle carpet python (Morelia spilota cheynei). J Exot Pet Med 31, 82-85.
  • Schnellbacher R, Olson E E & Mayer J (2012) Emergency presentations associated with cardiovascular disease in exotic herbivores. J Exotic Pet Med 21 (4), 316-327 PubMed.

Other sources of information

  • Shilliger L & Girling S (2019) Cardiology. In: Mader's Reptile and Amphibian Medicine and Surgery- E-Book. 3rd edn. Eds: Stephen J D & Scott J S. Saunders, USA.

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