The clinical presentation raises concern for submassive PE; therefore, the immediate focus is to evaluate the right ventricle (RV) for signs of failure.1 Discussion video, clip 1 begins with a standard parasternal long-axis view of the heart. This video shows the RV outflow tract and the left ventricle (LV), appearing grossly normal. The next view is the parasternal short axis, which serves to assess global LV function and septal kinetics. When there is pressure or volume overload in the RV, the interventricular septum will flatten during systole or diastole, respectively. This gives the LV a D-shaped appearance (the so-called “D-sign”). In this patient, both LV function and septal kinetics appear normal. In the apical four-chamber view, information on the RV size is provided. A ratio of RV to LV end-diastolic diameter > 1 is evidence for RV enlargement.2 This patient did not have an enlarged RV; however, this view did reveal an echogenic mass that appeared within the right atrium (RA). This is also seen on the subcostal view but is somewhat obscure. The next view shown is the inferior vena cava (IVC) in long axis. A soft tissue-like mass is seen obstructing the IVC and appears to have the same consistency as the liver. Given this finding, a parasternal short-axis view at the base of the heart was obtained (shown in Video 2). This is not a standard view; however, it can be easily obtained by the intensivist. Starting off with a basic parasternal short-axis view, slight angulation of the probe superiorly at the aortic valve level will result in a parasternal short-axis view of the base of the heart, which includes the RA, tricuspid valve, RV outflow tract, pulmonic valve, and pulmonary artery. In this image, a large RA mass is seen, with a mobile component extending into the RV. In addition, the RA mass seems contiguous with a nonmobile, soft tissue-like structure that obstructs the IVC. Following this, a bedside compression ultrasonography of the proximal lower extremity veins was done and was negative for thrombus (image not shown). Given the patient’s history of therapeutic INR values and the bedside ultrasonographic findings, tumor embolism was suspected rather than the common thromboembolic phenomenon. The patient underwent an ultrasound-guided percutaneous biopsy of the hepatic mass, confirming a diagnosis of hepatocellular carcinoma (HCC).