Abstract
This paper reports the case of an 88-year-old male with a history of chronic abdominal aortic aneurysm admitted to the emergency department with resting chest pain consistent with angina. Beta-blockade therapy triggered a cardiogenic shock, which motivated an urgent computed tomography scan and echocardiogram that confirmed high-output-related heart failure secondary to aortocaval fistula. (Level of Difficulty: Beginner.).