During the auscultation, the suspicion of a pericardial effusion can already be expressed due to muted heart tones, but it must then be checked, of course, by means of further diagnostic methods.
An X-ray examination is at this point insufficient to reveal only an enlargement of the heart silhouette, but which can be based on a variety of causes.
The ECG is somewhat better suited, since at least the excitation complexes differ from the normal image.
However, a safe and clear diagnose and also the cause research necessary for targeted treatment can only be carried out with the aid of a heart ultrasound examination. Thus, it can be clearly determined whether and how much fluid is present in the heart bag, and a statement can also be made about the type of an existing tumor. Hemangioma sarcomas are mostly found in the right atrium, while cardiac tumors lie directly around the aorta. Only mesotheliomas cannot be detected by ultrasound as they are numerous tumors the size of small grains of rice, which are distributed over the entire heart bag. They can be diagnosed exclusively by a heart muscle biopsy.
Similar to the mesothelioma, no cause can be found for idiopathic pericardial effusions, which is why this diagnosis can only be made on the basis of an exclusion procedure (with regard to the potential existence of mesothelioma but unfortunately also not without doubt).