Case Presentation (Michael H. Kim, MD) A 77-year-old woman was brought to a community hospital emergency room after an episode of syncope. She had been seated at the table and had passed out for '2 minutes. She had a history of hypertension, paroxysmal atrial fibrillation, and an abdominal aortic aneurysm repair 10 years earlier. She had no complaints immediately before the syncopal episode. When she awoke, she complained of mild chest and back discomfort that resolved quickly. Over the past several months, she had fatigue, malaise, and abdominal pain, and she had lost 10 lbs of weight. At the hospital, her systolic blood pressure was noted to be 47 mm Hg, and she was transferred to the University of Michigan Medical Center.