If your doctor suspects you have pericardial effusion, he or she will do a series of tests to look for it, identify possible causes and determine treatment.
Your doctor will perform a medical exam, including listening to your heart with a stethoscope.
An echocardiogram uses sound waves to create real-time images of your heart. With this procedure, a cardiologist can see the extent of pericardial effusion based on the amount of space between the two layers of the pericardium. An echocardiogram can also show decreased heart function due to pressure on the heart (tamponade).
Your cardiologist might be able to see whether one or more chambers of the heart have collapsed and how efficiently your heart is pumping blood. There are two types of echocardiograms:
- Transthoracic echocardiogram. This test uses a sound-emitting device (transducer) that is placed on your chest over your heart.
- Transesophageal echocardiogram. A tiny transducer on a tube is put down the part of your digestive tract that runs from your throat to your stomach (esophagus). Because the esophagus lies close to the heart, having the transducer placed there often provides a more-detailed image of the heart.
An electrocardiogram — also called an ECG or EKG — records electrical signals as they travel through your heart. Your cardiologist can look for patterns that suggest tamponade.
This can show an enlarged heart silhouette if the amount of fluid in the pericardium is large.
Other imaging technologies
Computerized tomography (CT) scans and magnetic resonance imaging (MRI) are imaging technologies that can detect pericardial effusion, although they're not generally used to look for the disorder. However, pericardial effusion may be diagnosed when these tests are done for other reasons.
If there's evidence of pericardial effusion, your doctor might order blood tests or other diagnostic tests to identify a cause.