Transthoracic echo—parasternal short view. There is extensive homogenous echodense mass superiorly (S) and anteriorly (A) in relation to the cardiac tissue. The most striking feature is that despite the infiltration and surrounding of the cardiac structures of the right atrium, right ventricle, and the aortic valve, there is no evidence of tamponade physiology. The homogenous echodensity encases the ascending aorta at the level of the aortic valve (∗), masking the coronary ostia leading into the coronary arteries.