50-something year old woman with Laennec’s cirrhosis, admitted with nausea and vomiting. Found to have physical findings of cirrhosis, including spider angiomas and Terry’s nails. Unexpectedly found to have markedly elevated JVP and a loud systolic flow murmur, concerning for high-output HF. Echo revealed a markedly elevated stroke volume index (70 (ml/m2). Right heart catheterization showed elevated filling pressures, low SVR, but normal cardiac output. However, the patient was in a junctional bradycardia at the time of the RHC, with a HR around 40, so the bradycardia was speculated to falsely lower the cardiac output.