Mesothelioma is capable of spreading to a patient’s major organs, including the heart. Patients who have pericardial or pleural mesothelioma suffer from a buildup of fluid in the heart lining. Such buildup in the pericardium can cause painful pressure on the heart, severe coughing, shortness of breath, and chronic chest pain. The most effective medical procedure to treat pericardial effusion is pericardiocentesis.
This procedure specifically targets the fluid in the pericardium and acts as a pericardial tap to remove excess fluid. Pericardiocentesis is not a new medical procedure, dating its origins to the mid-1800s. Over the many decades since its introduction, pericardiocentesis was the preferred method among doctors treating patients with a variety of diseases involving any form of pericardial effusion. Pericardiocentesis is still used for important diagnostic purposes . Unfortunately, a pericardial mesothelioma diagnosis cannot be confirmed by testing pericardial fluid alone since malignant mesothelioma cells are rarely found in pericardial fluid.
The Pericardiocentesis Procedure
In almost all cases, a pericardiocentesis is performed in a hospital setting. Depending on whether the patient is already being treated in the hospital, this procedure can be performed at bedside or in a surgical setting such as a catheterization lab. Patients will be advised to not eat for least six hours before the procedure, as well as abstaining from drinking any liquids. Often, patients receive an IV if the medical team feels it may be necessary to administer fluids or medications during the procedure.
At the start of the procedure, a local anesthetic is administered to the area just below a patient’s breastbone. Then, a long, thin needle is carefully guided to enter the pericardial sac in order to draw out excess fluid. To ensure a patient’s heart is not injured, doctors rely on an echocardiography (an ultrasound of the heart) to assist in positioning the needle. Once the needle is correctly positioned, it is then replaced by a catheter tube. This tube then drains the excess fluid from the heart into containers, which can take several hours.
Any minor chest pain or pressure experienced by patients a result of the needle insertion can be treated effectively with pain medication. Patients are carefully monitored after the procedure to make sure there are no complications.
Recurring Pericardial Effusion
There are instances when a patient may suffer from recurrent pericardial effusions. Several pericardiocentesis procedures may be performed, but it is also imperative to determine if a patient is experiencing multiple effusions due to pericardial tumors. Though CT scans are sometimes able to detect such tumors, another diagnostic test also can reveal mesothelioma tumors. An effusion cytology procedure tests the fluid extracted and can pinpoint malignant cells approximately 20 percent of the time.
A confirmed diagnosis also will require a biopsy of a patient’s tumor. To obtain a biopsy, percardiectomy surgery is required. This surgery also is helpful in relieving pericardial effusion and can assist in preventing the patient suffering from a continual recurrence of effusion.
Benefits of Pericardiocentesis
Doctors treating pericardial effusion will recommend the pericardiocentesis procedure. It is proven to ease chronic and painful symptoms, and known for improving patients’ quality of life. In addition, mesothelioma cancer symptoms can effectively be treated by undergoing the procedure.