Differential

• Pleural fluid in the parasternal long-axis the descending aorta remains posterior to pericardial fluid. Pleural effusion is posterior to the descending aorta. Lateral chest wall views are helpful.
• Epicardial fat adipose between the visceral pericardium and the myocardium, within the pericardial sac is echogenic on the parasternal long-axis view. Pericardial fluid typically appears hypoechoic.
• Ascites invariably in subcostal views, anterior to the right cardiac chambers. Ascites is typically detected in other peritoneal spaces as well.

Pleural effusion

Ascites