A man in his 70s presented to the emergency department with 4 days of progressive dizziness, shortness of breath, and chest pain on exertion. He denied any infective symptoms, palpitations, syncopal episodes, or chest pains at rest.

His medical history included type 2 diabetes, hypertension, and hyperlipidemia. He had an uncomplicated open cholecystectomy in 2008. He was an ex-smoker with a 25-pack-year history. He had no significant family medical history. His prescribed medications were metformin MR, 1000 mg twice per day; sitagliptin, 100 mg once per day; gliclazide, 80 mg twice per day; bendroflumethiazide, 2.5 mg once per day; lisinopril, 20 mg once per day; and atorvastatin, 20 mg once per day.