Cardiologists in Yelahanka Pericardial effusion and tamponade Drainage of a pericardial effusion can usually be performed under ECG monitoring by percutaneous puncture from near the xiphisternum. This procedure is urgent and can be life-saving if tamponade has occurred. A drain may be left in situ or the catheter tube may be removed and repeat echo performed regularly to look for reaccumulation. Effusions due to pericardial inflammation as a result of a viral infection or following cardiac surgery or infarction (Dressler’s syndrome) may reaccumulate unless anti-inflammatory treatment is given. Non-steroidal anti-inflammatory drugs are usually effective. They often have to be given in big doses and weaned over several weeks. Occasionally control can be achieved only with steroids. Reaccumulation that cannot be prevented (often due to malignancy) may be an indication for the surgical insertion of a pericardial window. This large hole in the sack allows the pericardial fluid to drain into the pleural space where it can do less harm and can usually be reabsorbed. Cardiac function does not seem to be adversely affected by loss of part or all of the pericardial sack.