A 40-year-old male presented with shortness of breath and a history of ischemic heart disease and previous open heart surgery. Imaging showed a pericardial effusion, cardiomyopathy, and multivalve dysfunction. Further tests revealed a scarred anterior wall and pneumonia. A 65-year-old lady presented with shortness of breath and chest x-ray showed acute left ventricular failure. Her BNP was tested. A 17-year-old male presented with fever and was found to have aortic valve vegetations due to Brucella. A 42-year-old male with a history of stroke but no chest pain was found to have hypertrophic obstructive cardiomyopathy on ECG and echo, with the