The patient is a 95-year-old gentleman who presents to the ED complaining of chest pain. The first episode was at 3 PM the day prior to admission, pressure-like described as left-sided, and pressure-like it resolved without intervention and then reoccurred again at 3 AM in the morning of presentation to the hospital. His chest pain had resolved prior to arriving in the ED. His medical history is significant for atrial fibrillation, congestive heart failure, hypertension and he has age related macular degeneration. It is to be noted that his hemoglobin is 8.5 and 26.4. On admission he does have a BUN of 29. Cardiac enzymes are negative. He is known to be in atrial fibrillation. He is on Coreg, Digoxin and Pradaxa. It is to be noted in
