Case Presentation: A 57-year-old male with HIV, heart failure with reduced ejection fraction, and hypothyroidism initially presented for dyspnea on exertion, found on EKG to have electrical alternans. Telemetry showed intermittent type2 second degree AV block. Transthoracic echocardiogram was notable for large pericardial effusion, ejection fraction 35%, grade 1 diastolic dysfunction, early diastolic right ventricular […]