Leo, a 5-year-old neutered male Boxer, was initially presented to The COVE Cardiology Service for further evaluation of two episodes of collapse that occurred on a single day three weeks earlier when he became overexcited and pulled very hard on his leash. The first episode occurred during an altercation with another dog over ice cream, and the second occurred after becoming excited over the neighbor’s dog. Both episodes are described as “four legs splaying out from under him, he hit the ground, rolled over on his side, bounced back up, was a bit ‘glassy eyed’ and then took off completely normal."