Case Presentation: 71M with PMHx of pAfib on Eliquis, HTN, and CKD3a admitted to MICU as transfer for AHRF with severe pulmonary HTN s/p intubation, pressor support, NGT placement during planned TEE cardioversion for persistent Afib. On arrival active upper GIB was present through his NGT and emergent EGD revealed large distal esophageal mass; cytology [...]