A 46 year old woman with a history of dilated cardiomyopathy, an ejection fraction of 10% and a left ventricular thrombus, HIV, hypertension, and a history of hepatitis B, was admitted with increasing shortness of breath, paroxysmal nocturnal dyspnoea (PND), orthopnoea, and pedal oedema over a three week period. On admission, the patient was in respiratory …