Case 2: 57 year old female with COPD and advance lung cancer, admitted with acutely worsen SOB. PE protocol CT demonstrated a large pericardial effusion. She is brought to the OR for an elective pericardial window. In the preoperative bay, the patient appears comfortable and conversant. Below is her arterial line tracing prior to induction. A focused cardiac ultrasound exam was also performed prior to induction.