At a Glance
Why Get Tested?
Pericardial fluid analysis is very rarely done today because other less invasive tests exist to help determine the cause of the fluid accumulating around the heart.
When to Get Tested?
Pericardial fluid removed for therapeutic reasons (pericardial tamponade) is often routinely sent for analysis. Also if a bacterial or malignant cause is suspected or the cause of a large collection is obscure.
A sample of fluid collected by a doctor from the pericardial sac using a procedure called a pericardiocentesis
The Test Sample
What is being tested?
Pericardial fluid is a liquid that acts as a lubricant for the movement of the heart. It is found in small quantities between the two layers of the pericardium. Pericardial fluid is produced by mesothelial cells in the membranes and acts to reduce friction as the heart pumps blood.
A variety of conditions and diseases can cause inflammation of the pericardium (pericarditis) and/or excessive accumulation of pericardial fluid (pericardial effusion) for example; inflammation, cirrhosis, congestive heart failure, autoimmune disorders or metastatic cancer.
Pericardial fluid analysis comprises a group of tests used to determine the cause: red and white blood cell counts and differential, cytology, Gram stain, fungal culture and acid fast staining for tuberculosis. Biochemical tests that may be performed are pH, glucose, lactate dehydrogenase (LDH) and total protein.
How is the sample collected for testing?
A sample of fluid is collected from the pericardial sac by a doctor with a syringe and needle using a procedure called a pericardiocentesis. This is usually done in a special laboratory under guidance by echocardiography or fluoroscopy and ECG monitoring.
Is any test preparation needed to ensure the quality of the sample?
No special preparation is usually needed
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Dudzinski DM, Mak GS, Hung JW. Pericardial diseases. Curr Probl Cardiol. 2012 Mar;37(3):75-118. doi: 10.1016/j.cpcardiol.2011.10.002.
Imazio M, Spodick DH, Brucato A, et al. Controversial issues in the management of pericardial diseases. Circulation 2010;121:916-28. 5.