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This echo report describes a patient who developed cardiac temponade in the post-anesthesia care unit after laser lead extraction at electrophysiology laboratory. Diagnosis was readily established by transthoracic echocardiography and this lead to good outcome. Transthoracic ultrasound helps in preoperative evaluation of non-cardiac surgical patients and also postoperative care of hemodynamically unstable patients. This describes the importance of training and competence in transthoracic ultrasound for anesthesiologists.