Emergency Medical Technician (EMT) Intermediate Practice Exam

Which layer of the heart is penetrated to remove fluid during an emergent procedure?

1. Endocardium

2. Myocardium

3. Pericardium

4. Epicardium

The correct answer is: Pericardium

The correct choice is the layer of the heart that surrounds and contains the heart itself, known as the pericardium. In emergent situations, fluid accumulation in the pericardial space—such as in the case of pericardial effusion—can compromise the heart’s ability to function effectively. To relieve this pressure, a procedure called pericardiocentesis may be performed, where fluid is aspirated from the pericardial sac. The pericardium is the outer protective layer that encases the heart and provides a lubricated environment that reduces friction during heartbeats. This structural role makes it essential for procedures aimed at draining excess fluid without causing injury to the heart itself or the other inner layers of the heart. The other layers—the endocardium, myocardium, and epicardium—are not typically accessed for fluid removal in emergency circumstances. The endocardium lines the heart chambers and valves, the myocardium is the muscular layer responsible for heart contractions, and the epicardium is the outer layer of the heart wall that also forms part of the pericardium. Attempting to penetrate these layers for fluid removal would risk severe complications, such as damaging the heart muscle or valves.