42-year-old male, day 6 ICU, following admission with shock, with type A thoracic aortic dissection, right CVA and severe aortic regurgitation, and now post Bentall's procedure. Clinical signs included on sedation and muscle relaxants, sternotomy scar, right groin wound, prosthetic aortic valve, bronchial breath sounds at left base and decreased air entry right base. o Candidates were directed to examine his cardiovascular system with a view to finding the cause for his initial collapse.