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worldcardiacvision.org/abnormal-hearts/pericardial-effusion

This is a moderate sized pericardial effusion that is located posteriorly to the heart. The inferior vena cava is dilated, greater (50%) inspiratory change is a commonly observed sign in significant effusion cases. The inflow respiratory variations of the mitral valve and tricuspid valve are also very important indicators for tamponade.
The pericardium has two layers, and the space between the layers normally contains a thin layer of fluid. But if the pericardium of the heart is diseased or injured, the resulting inflammation can lead to excess fluid. The fluid can build up around the heart causing cardiac tamponade. In the case of tamponade, there is severe compression of the heart that impairs its ability to function. Cardiac tamponade resulting from pericardial effusion can be life-threatening and is a medical emergency, requiring intervention. In the case of intervention, urgent drainage of the fluid will be performed. The echocardiography-guided technique involves indentifying the location of pericardial fluid and entering with a needle at a point on the chest wall where the largest fluid accumulation is closest to the skin. This also aids in avoiding vital structures.

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