57-year-old man with MR s/p mechanical MVR (2 years ago), CAD (STEMI + VF Arrest (5 years ago) s/p DES to distal LM/prox LAD), HF with recovered LVEF (45% improved to 60%), HTN, HLD, DM, PAF, who presented with dyspnea and chest pain, new O2 requirement and with likely L-sided atrial flutter. Has undergone diuresis, RHC/LHC, CT chest. Found to have bilateral GGO’s on CT, evaluated by pulmonary and ID. Also with acute on chronic anemia.