Structures piercing during pericardiocentesis:
a. Skinb. Diaphragm .
c. Intercostals muscles.
d.Pleura
e. Rectus Muscle
Ans.
(A) Skin; (B) Diaphragm (E) Rectus
muscle
• Pericardiocentesis involves removal of pericardial fluid
by percutaneous catheterisation of the pericardial sac. The subxiphoid ‘blind’
approach to pericardio-centesis has been the traditional approach, which
involves placing the patient in a supine 300 - 45° head-up position to facilitate the movement of the effusion
towards the anterior chest wall.
• Indications
Therapeutic
- Cardiac tamponade
- Haemodynamic compromise due to large/rapidly developing
pericardial effusion
- Management of large pericardial effusion (>20 mm
separation of pericardial membranes on echocardiography)
Diagnostic :
- Obtaining pericardial fluid for analysis
- Pericardioscopy
- Epicardial or pericardial biopsy
Contraindications
- Aortic dissection as cause for pericardial effusion
- Aortic dissection as cause for pericardial effusion
- Uncorrected
bleeding diathesis
- Anticoagulation
- Marked
thrombocytopenia (<50,000/mm3)
- Loculated
pericardial effusion
- Small pericardial
effusion
- Posteriorly
located pericardial effusion
The structures pierced during pericardiocentesis
are:
- Skin &
subcutaneous tissues
- Rectus muscle
- Transverses
abdominis
- Diaphragm
- Parietal
pericardium.
