心嚢穿刺
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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/12/24 18:05:52」(JST)
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| Pericardiocentesis |
| Intervention |
| ICD-9-CM |
37.0 |
| MeSH |
D020519 |
| MedlinePlus |
003872 |
In medicine, pericardiocentesis is a procedure where fluid is aspirated from the pericardium (the sac enveloping the heart).
Contents
- 1 Position
- 2 Process
- 3 Indications
- 4 Similar procedures
- 5 External links
- 6 References
Position
The patient undergoing pericardiocentesis is positioned supine with the head of the bed raised to a 30- to 60-degree angle. This places the heart in proximity to the chest wall for easier insertion of the needle into the pericardial sac. Anatomically, the procedure is carried out under the xiphoid process, up and leftwards.[1]
Process
It is generally done under ultrasound guidance, to minimize complications. There are two locations that pericardiocentesis can be performed without puncturing the lungs.[2]
- One location is through the 5th or 6th intercostal space at the left sternal border at the cardiac notch of the left lung and is also called as parasternal approach.
- The other location is through the infrasternal angle and is also called subxiphoid approach.[3]
Indications
Indications include cardiac tamponade, as well as the need to analyze the fluid surrounding the heart. Cardiac tamponade is a condition in which an accumulation of fluid within the pericardium creates excessive pressure, which then prevents the heart from filling normally with blood. This can critically decrease the amount of blood that is pumped from the heart, which can be lethal. The removal of the excess fluid reverses this dangerous process. Examples of the need for fluid analysis would be to differentiate whether a fluid collection within the pericardium is due to an infection, spread of cancer, or possibly an autoimmune condition.
Similar procedures
In cases where longer term drainage is needed, the cardiothoracic surgeon can create a pericardial window. This involves the removal of a section of the pericardium, and the placement of a chest tube.
External links
- MedlinePlus Encyclopedia 003872
- med/3560 at eMedicine
- Trauma Man: Images of pericardiocentesis being performed on a simulator
- Cardiac Surgery in the Adult: Pericardial disease
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Surgery and other procedures involving the heart (ICD-9-CM V3 35–37+89.4+99.6, ICD-10-PCS 02)
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| Surgery and IC |
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Heart valves
and septa
|
- Valve repair
- Valvulotomy
- Mitral valve repair
- Valvuloplasty
- Valve replacement
- Aortic valve repair
- Aortic valve replacement
- Ross procedure
- Percutaneous aortic valve replacement
- Mitral valve replacement
- production of septal defect in heart
- enlargement of existing septal defect
- Atrial septostomy
- Balloon septostomy
- creation of septal defect in heart
- Blalock–Hanlon procedure
- shunt from heart chamber to blood vessel
- atrium to pulmonary artery
- Fontan procedure
- left ventricle to aorta
- Rastelli procedure
- right ventricle to pulmonary artery
- Sano shunt
- compound procedures
- for transposition of great vessels
- Jatene procedure
- Mustard procedure
- for univentricular defect
- Norwood procedure
- Kawashima procedure
- shunt from blood vessel to blood vessel
- systemic circulation to pulmonary artery shunt
- Blalock–Taussig shunt
- SVC to the right PA
- Glenn procedure
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|
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Cardiac vessels
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- CHD
- Angioplasty
- Bypass/Coronary artery bypass
- MIDCAB
- Off-pump CAB
- TECAB
- Coronary stent
- Bare-metal stent
- Drug-eluting stent
- Bentall procedure
- Valve-sparing aortic root replacement
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|
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Other
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- Pericardium
- Pericardiocentesis
- Pericardial window
- Pericardiectomy
- Myocardium
- Cardiomyoplasty
- Dor procedure
- Septal myectomy
- Ventricular reduction
- Alcohol septal ablation
- Conduction system
- Maze procedure
- Cox maze and minimaze
- Catheter ablation
- Cryoablation
- Radiofrequency ablation
- Pacemaker insertion
- Left atrial appendage occlusion
- Cardiotomy
- Heart transplantation
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Diagnostic
tests and
procedures |
- Electrophysiology
- Electrocardiography
- Vectorcardiography
- Holter monitor
- Implantable loop recorder
- Cardiac stress test
- Bruce protocol
- Electrophysiology study
- Cardiac imaging
- Angiocardiography
- Echocardiography
- TTE
- TEE
- Myocardial perfusion imaging
- Cardiovascular MRI
- Ventriculography
- Radionuclide ventriculography
- Cardiac catheterization/Coronary catheterization
- Cardiac CT
- Cardiac PET
- sound
- Phonocardiogram
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| Function tests |
- Impedance cardiography
- Ballistocardiography
- Cardiotocography
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| Pacing |
- Cardioversion
- Transcutaneous pacing
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|
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Index of the heart
|
|
| Description |
- Anatomy
- Physiology
- Development
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| Disease |
- Injury
- Congenital
- Neoplasms and cancer
- Other
- Symptoms and signs
- Blood tests
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| Treatment |
- Procedures
- Drugs
- glycosides
- other stimulants
- antiarrhythmics
- vasodilators
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|
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References
- ^ Sam, Amir H.; James T.H. Teo (2010). Rapid Medicine. Wiley-Blackwell. ISBN 1-4051-8323-3.
- ^ http://www.sonoguide.com/pericardiocentesis.html
- ^ http://www.sonoguide.com/pericardiocentesis.html
UpToDate Contents
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English Journal
- Sealing of a dual feeding coronary artery perforation with homemade spring guidewire.
- Hartono B1, Widito S, Munawar M.
- Cardiovascular intervention and therapeutics.Cardiovasc Interv Ther.2014 Oct 10. [Epub ahead of print]
- Coronary artery perforation (CAP) after percutaneous coronary intervention is a rare, but potentially life-threatening complication. The source of the bleeding is usually from one of the coronary arteries. In the era of chronic total occlusion technique, retrograde approach strategy sometimes is per
- PMID 25301012
- Fibrinous pericarditis and pericardial effusion in three neonatal foals.
- Armstrong S1, Raidal S, Hughes K.
- Australian veterinary journal.Aust Vet J.2014 Oct;92(10):392-9. doi: 10.1111/avj.12238. Epub 2014 Sep 1.
- CASE SERIES: Three foals, aged between 5 and 10 days, were presented for assessment of lethargy, abdominal pain and joint effusion. Fibrinous pericarditis and pericardial effusion (PE) were recognised in each foal and considered as sequelae to systemic inflammatory response syndrome (SIRS) and suspe
- PMID 25179536
- Purulent pericarditis after transbronchial biopsy.
- Tachjian A1, Shafer KM2, Denkinger C1, Pinto DS3.
- The Canadian journal of cardiology.Can J Cardiol.2014 Oct;30(10):1250.e19-21. doi: 10.1016/j.cjca.2014.04.013. Epub 2014 Apr 18.
- A 28-year-old woman experienced hypotension and unresponsiveness. She had undergone bronchoscopy with needle biopsy 2 weeks before admission to evaluate hilar lymphadenopathy given suspicion of sarcoidosis. She had an elevated white blood cell count of 28,000/μL and a serum creatinine level of 4.0
- PMID 25138484
Japanese Journal
- 症例 肺癌による癌性心膜炎の再発にCTガイド下心ドレナージ術を施行した1例
- 心穿刺・心切開 (特集 研修医のためのER診療マニュアル(2)基本手技・検査編) -- (胸部)
Related Links
- Post Procedure Care Antibiotics are not routinely administered. Following relief of pericardial tamponade, some patients may become hypertensive. If drainage stops or slows, the catheter should be repositioned by pulling it back out ...
- Pericardiocentesis. Cardiac tamponade is a time sensitive, life-threatening condition that requires prompt diagnosis and management. ... Cine loop depicting subxiphoid cardiac tamponade. Video courtesy of Meghan ...
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Related Pictures
★リンクテーブル★
[★]
- 英
- pericardiocentesis (M), pericardial paracentesis, puncture of pericardium
- 同
- 心膜穿刺、心膜腔穿刺
- 関
- 心嚢穿刺術
[show details]
- 適応：心タンポナーデによるショック(脈圧20mmHg以下、中心静脈圧20cmH2O以上)
- 穿刺部位：剣状突起下(剣状突起下であって、剣状突起左縁と左肋骨弓の交点(Larry's point)から左肩に向け腹壁と45度の高さで穿刺。
[★]
- 英
- pericardiocentesis
- 同
- 心膜穿刺術
- 関
- 心嚢穿刺
[show details]
[★]
- 関
- pericardiectomy、pericardiocentesis