In our everyday practice, we see ulcers in dialysis patients; we usually think blindly about calciphylaxis. Sometimes even we start patients on empiric treatment based on that assumption, but let us assume that something simpler may be going on, as seen in this case.

Chest pain immediately after atrial fibrillation ablation is seen essentially with every case, and we counsel the patients that it is expected. On the other hand, delayed chest pain is not always expected and usually points towards a procedure complication, as shown in this case.

HIT is a massive thrombotic storm. The incidence of thrombotic complications is up to 50%, and the mortality rate is up to 20% in untreated cases. The patient’s presentation was subtle, with mild thrombocytopenia. The consequences would have been catastrophic if cardioversion was done using the standard guidelines.

Acute decompensation in patient with COVID19 is usually a consequence of worsening ARDS , however acute pulmonary embolism and acute pneumothorax are frequently recognized causes of acute decompensation , the later causes are treatable and having high index of suspicion is very important in order not to miss them.

Mechanical complications of myocardial infarction are rare. However, the consequences are catastrophic if missed; here, we present a case highlighting the red flags that can guide the diagnosis of mechanical complications of MI.

Rash is frequently seen in patients with leukemia either as a sequence of thrombocytopenia, or as result of infection or allergic drug rash, however sometimes rash is pointing towards fatal complications of underlying drug therapy or underlying disease , not being aware of these alarming signs can have fatal consequences.