very young patient with dyspnoea, tachycardia, silent heart murmur and positive kussmaul-sign (positive Beck-Trias!!). in clinical history a carcinoma with pulmonary, cerebrale and osseous meastases are known.
In TTE I could found a distinct pleural effusion with pulmonary consolidation (after tapping we actually know that it is malignant effusion) and a pericardial effusion with beginning tamponade with decrease of transmitral flow in inspiration and increase of transtricuspidal flow in inspiration.
Amazing clip!!! congratulations.! thanks for share!