Pericardial effusion is usually revealed with use of subcostal scanning plane. The fluid is usually localised dorsally and caudally due to gravitational force. Pericardial effusion often mounts on diaphragm and liver in a patient in the semi-sitting position. It may be challenging to visualise central fibrous part of the diaphragm since it is thin at this region. Ascites (tension one), as well as pericardial effusion, may both result in the compression of heart and development of tamponade. Thus, it is necessary to differentiate between these because, in case of ascites, the puncture may be performed more safely, i.e. further from the heart.
Following case shows the point of care ultrasonography (POCUS) in a patient suffering from ARDS and receiving mechanical ventilation. The patient was lying slightly at her left side.