The November 2023 issue of PCCM is focused entirely on cardiac critical care topics. The feature article describes prevalence and risk factors of children exposed to toxic levels of cardiovascular medications, while clinical investigations cover a breadth of topics from using a psychosocial care model, extracorporeal cardiopulmonary resuscitation (ECPR) and extracorporeal membrane oxygenation (ECMO) in heart disease, minimizing blood draws, and more. A couple of articles highlight airway management and complications in patients with heart disease. Special articles and a clinical physiology review make this issue quite an interesting read.