Echocardiogram showing (a) pericardial effusion and pleural effusion at presentation (from subcostal imaging plane), (b) progression of pericardial effusion with fibrinous material (from short axis plane), (c) mitral valve Doppler inflow signal with reversal of E and A waves, suggestive of restrictive myocardial disease with impaired diastolic function, (d) impaired diastolic function suggested by low Tissue Doppler signal, and (e) preserved left ventricular systolic function.