Because pericardial effusions usually occur in advanced cancer or in the last few weeks of life, extensive diagnostic testing may be less important than relief of symptoms. The following tests and procedure may be used to diagnose pericardial effusion:
Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
Echocardiography: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs of the chest. The echoes form a picture of the heart's position, motion of the walls, and internal parts such as the valves.
Electrocardiogram (EKG or ECG): A recording of the heart's electrical activity to evaluate its rate and rhythm. A number of small pads (electrodes) are placed on the patient’s chest, arms, and legs, and are connected by wires to the electrocardiograph machine. Heart activity is then recorded as a line graph on paper. Electrical activity that is faster or slower than normal may be a sign of heart disease or damage.
Pericardiocentesis: The removal of fluid from the pericardium using a needle inserted through the chest wall. The physician may use an echocardiogram to view the movement of the needle inside the chest. This procedure can be used to drain fluid from an effusion and reduce pressure on the heart. To diagnose malignant pericardial effusion, the fluid is examined under a microscope to check for cancer cells. The fluid may also be checked for signs of infection.
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