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Pericardiocentesis- Diagnosis, Procedure and Treatment in India
Medical tourism provides Pericardiocentesis treatment in India and other medical treatments and thus has emerged to be an upcoming pioneer in this field of healthcare sectors in the world. Indian healthcare units are equipped to handle all sorts of cases from simple to complex using latest clinical procedures. The commitment of its surgeons to the prevention and treatment of disease has led to the achievement of better outcomes and improved quality of life for thousands of patients. Indian healthcare providing Pericardiocentesis treatment in India ensures that patient"s experience is safe and comfortable, with the highest standards of both medical and non-medical services.
In medicine, pericardiocentesis is a procedure where fluid is aspirated from the pericardium (the sac enveloping the heart). It is generally done under ultrasound guidance, to minimize complications. There are two locations that pericardiocentesis can be performed without puncturing the lungs.
The purpose of Pericardiocentesis
The heart is surrounded by a membrane covering called the pericardial sac. The sac consists of two layers, the parietal (outer) and visceral (inner) layer, and normally contains a small amount of fluid to cushion and lubricate the heart as it contracts and expands. When too much fluid gathers in the pericardial cavity, the space between the pericardium and the outer layers of the heart, a condition known as pericardial effusion occurs. Abnormal amounts of fluid may result from:
- Pericarditis, infection caused by inflammation of the pericardial sac
- Trauma, such as an abnormal collection of blood due to an accident
- Surgery or invasive heart procedures
- Heart attack (myocardial infarction) or congestive heart failure, which occurs when the heart looses its pumping capability due to a heart condition
- Kidney (renal) failure
- Cancer (producing malignant effusions)
The rate of pericardial fluid accumulation is important. If fluid accumulation develops slowly, then problems with blood flow will not develop until fluid retention becomes massive. Blood can also enter the pericardial sac (hemopericardium) due to trauma, blood-thinning medications, or disease. When there is rapid or excessive build-up of fluid or blood in the pericardial cavity, the resulting compression on the heart impairs the pumping action of the vascular system (a condition called cardiac tamponade). Pericardiocentesis can be used in such an emergency situation to remove the excess accumulations of blood or fluid from the pericardial sac. For diagnostic purposes, pericardiocentesis may be advised in order to obtain fluid samples from the sac for laboratory analysis.
Diagnosis/symptoms of Pericardiocentesis
The typical symptom associated with patients requiring Pericardiocentesis is chest pain, usually indicative of severe effusion. Patients with cardiac tamponade commonly have dyspnea (difficulty breathing) and those with an infection may have fever. Some patients may have a hoarse voice from compression of a nerve called the recurrent laryngeal nerve; the pericardial sac may be so large that it pushes or compresses neighboring anatomical structures. Physical symptoms may vary, dependent both on size and the rate of filling of the pericardial effusion. Patients can also present with the following physical symptoms:
- Tachycardia, an increased heart rate
- Tachypnea, an increase in breathing rate
- Jugular vein enlargement
- Narrow pulse pressure (pulsus paradoxus)
- Pericardial friction rub
- Elevated central venous pressure
- Hiccups from esophageal compression
Ewart's sign (dull sound when the doctor taps the chest, tactile fremitus, egobronchophony). The procedure can be performed in an emergency room, ICU, or at the bedside. Before the procedure patients should have an echocardiogram and basic blood analysis. No special dietary restrictions are required for pericardiocentesis. The patient will receive an IV line for sedation or other necessary medications and an electrocardiogram (ECG) to monitor cardiac activity. The patient must lie flat on the table, with the body elevated to a 60-degree angle. If the test is elective, then food and water restriction is recommended for six hours before the test. For infants and children, preparation depends on the child's age, level of trust, and previous exposure to this or similar procedures.
The patient going for Pericardiocentesis procedures should sit with the head elevated 30-40 degrees. This is done to maximize fluid drainage. A site close to the pericardial sac is chosen, and if time permits the patient is sedated. The puncture site is cleaned with an antiseptic iodine solution, and the area is shaved and anesthetized with lidocaine (a local anesthetic). During the Pericardiocentesis procedures a long cardiac needle is inserted under the xiphoid (the bottom of the breastbone) approach on the left side of the heart using guided imagery into the chest wall until the needle reaches the pericardial sac. Usually, the patient may experience a sensation of pressure when the tip of the needle penetrates the pericardial sac. When guided imagery confirms correct placement, fluid is aspirated from the sac. If the procedure is performed for diagnostic purposes, aspirated fluid can be collected in specimen vials and sent for pathological analysis (i.e. for cancer cell detection in cases where malignant effusion is suspected), or the fluid is just removed if the procedure was performed urgently (i.e. cardiac tamponade). For therapeutic cases, a pericardial catheter may be attached and fixed into position to allow for continuous drainage. When the needle is removed, pressure is applied for five minutes at the puncture site to stop the bleeding, and the site is bandaged.
Risks of Pericardiocentesis
Pericardiocentesis is an invasive procedure and therefore has associated risks. Complications are possible, but have become less common due to guided imaging techniques that improved the past blind approach. Possible risks include:
- Puncture of the myocardium, the outer muscle layer of the heart
- Puncture of a coronary artery, a blood vessel that supplies blood to heart muscle
- Myocardial infarction (heart attack)
- Needle induced arrhythmias (irregular heartbeats)
- Pneumopericardium, air entry into the pericardial sac
- Infection of the pericardial membranes (pericarditis)
- Accidental puncture of the stomach, lung, or liver
Why Pericardiocentesis treatment in India?
Pericardiocentesis treatment in India is done under best medical supervision. Medical tourism is a developing concept whereby people from world over visit India for their medical and relaxation needs. Most common treatments are heart surgery, knee transplant, cosmetic surgery, eye surgery, various cancer surgeries, dental care etc. The reason India is a favorable destination is because of its infrastructure and technology which is in par with developed countries. India has some of the best hospitals and treatment centers in the world with the best facilities. Pericardiocentesis treatment in India comes at state of the art Hospitals and the best qualified doctors. With the best infrastructure, the best possible Medical facilities, accompanied with the most competitive prices, you can get the treatment done in India at the lowest charges.
For further details on the surgical treatment of Pericardiocentesis treatment in India visit us at http://www.forerunnershealthcare.com or mail your queries at firstname.lastname@example.org +91-9371136499, +91-9860755000
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