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Tests and diagnosis
By Mayo Clinic staffYour doctor will do a series of tests to look for pericardial effusion, identify possible causes and determine treatment. For some of the exams, your doctor may refer you to a cardiologist.
Medical exam
Your doctor will perform a medical exam. In particular, he or she will listen to your heart with a stethoscope. If your pericardium is inflamed, your doctor may hear a high-pitched, scratchy sound called a friction rub. If there's a large amount of fluid accumulated, your heartbeat may be muffled or sound distant.
Echocardiogram
The most commonly used test to diagnose pericardial effusion is an echocardiogram. An echocardiogram uses sound waves to create real-time images of your heart. With this procedure a cardiologist can determine the extent of pericardial effusion based on the amount of space present between the two layers of the pericardium. An echocardiogram can also reveal evidence of tamponade, or impaired heart function due to pressure on the heart. Your cardiologist may 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:
- A transthoracic echocardiogram uses a sound-emitting device (transducer) that is placed on your chest over your heart.
- A transesophageal echocardiogram uses a tiny transducer on a tube that's inserted down the esophagus, the part of the digestive tract that runs from the throat to the stomach. Because the esophagus lies close to the heart, having the transducer placed there provides a detailed image of the heart.
Electrocardiogram
An electrocardiogram — also called an ECG or EKG — records electrical signals as they travel through your heart. Your cardiologist can look for patterns among these signals that are characteristic of tamponade.
Chest X-ray
A chest X-ray may show an enlarged silhouette of your heart if the amount of fluid in the pericardium is large.
Other imaging technologies
Computerized tomography (CT) and magnetic resonance imaging (MRI) are imaging technologies that can detect pericardial effusion, although they're not commonly used to look for the disorder. However, pericardial effusion may be diagnosed when these tests are done for other reasons.
Other tests
If your doctor finds evidence of pericardial effusion, he or she may order blood tests or other diagnostic tests to identify an underlying cause.
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- Cardiopulmonary syndromes (PDQ®): Malignant pericardial effusion. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/supportivecare/cardiopulmonary/HealthProfessional. Accessed Nov. 1, 2008.
- Martin M, et al. Pericardial disease. In: Libby P, et al., eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/108738632-2/0/1549/0.html. Accessed Oct. 29, 2008.
- Khunnawat C, et al. Cardiovascular manifestations in human immunodeficiency virus-infected patients. American Journal of Cardiology. 2008;102(5):635-642.
- Maisch B, et al. Guidelines on the diagnosis and management of pericardial diseases executive summary: The task force on the diagnosis and management of pericardial diseases of the European Society of Cardiology. European Heart Journal. 2004;25(7):587-610.
- Ristic AD, et al. Management of pericardial effusion: The role of echocardiography in establishing the indications and the selection of the approach for drainage. Herz. 2005;30(2):144-150.
