In this Winter 2016 edition of Annals of B Pod, we focus on cardiovascular emergencies and their management in the Emergency Department and beyond. In our new Air Care column, we write about the prehospital management of patients with profound cardiogenic shock requiring intra-aortic balloon pumps. In our recurring pharmacology column, we discuss the ED management of hypertensive emergency. Back in B Pod, Dr. Scanlon writes about a rare complication of renal failure in a patient with a large uremic pericardial effusion, and in our new procedure piece, we walk through the technical steps required to perform an emergent pericardiocentesis. On the back page, our EKG corner goes over the modified Sgarbossa criteria. This issue of Annals of B Pod gets back to the heart of it all, highlighting what makes residency so rewarding: interesting pathology, challenging procedures and clinical excellence.