If you want to challenge your knowledge of CV physiology and get used to patients near the end of their rope, this is the month for you! I don't believe you will see a higher level acuity ICU. From post lung and heart transplants, mechanical assist devices (ECMO, VADs, Impellas, balloon pumps), I saw patients pushing to extraordinary limits and live to tell the tale. Our teams are made up of CV and ICU fellows, residents, and advanced care practitioners. Overall takeaways of the rotation include principals of acute right and left heart failure, weaning from ECMO and VADs, and interpretation of PA catheters. During the day, the team splits the patients, and we work closely with the advanced heart failure team which we can learn a lot from. However, on nights, you will generally cover the ICU floor solo as the attending watches the CV recovery patients fresh from the OR many floors away. These are the kinds of things you will experience at SLICU where there is no shortage of adrenaline.