Abstract
In this chapter we discuss the indications, as well as the echocardiographic/Doppler diagnosis of pericardial tamponade. We provide an in depth description of how to perform an echocardiographic guided pericardiocentesis. A detailed description is given on how to prepare for performing pericardiocentesis, equipment needed, use of local analgesia, exclusion criteria, and the optimal site for pericardial puncture as dictated by echocardiographic guidance. We explain different approaches for pericardial access, how to identify the angle for needle insertion and to determine the depth of needle penetration that is both safe and required. We describe the use of pericardial catheter drainage, laboratory studies that should be performed on the pericardial fluid and management of pericardial drain, as well as when the drain should be removed. We outline our use of medications before (local analgesia), and after the procedure (anti-staphlococcal coverage while the pericardial catheter is in place and the use of colchicine and non-steroidal anti-inflammatory agents). Detailed imaging is provided for the echocardiographic findings as well as step-by-step photo demonstration of the pericardiocentesis procedure.
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© 2016 Springer International Publishing Switzerland
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Siegel, R.J., Arsanjani, R. (2016). Echo Guided Pericardiocentesis. In: Picard, M., Passeri, J., Dal-Bianco, J. (eds) Intraprocedural Imaging of Cardiovascular Interventions. Springer, Cham. https://doi.org/10.1007/978-3-319-29428-5_2
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DOI: https://doi.org/10.1007/978-3-319-29428-5_2
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