We report two cases of patients referred for assessment to a heart failure clinic. The first case is a 62 year old woman with a history of previous myocardial infarction. The second case is a 65 year old woman with a history of heart failure, chest pains, smoking, and hypertension. Both patients presented with symptoms of moderate-to-severe heart failure. Echocardiography in both cases was limited by suboptimal image quality but showed significant left …