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Age: 68 Gender: Male Medical History: Hypertension, Type 2 Diabetes Mellitus, Ischemic Heart Disease (prior MI 5 years ago), Moderate Chronic Kidney Disease (eGFR 42 ml/min/1.73m), Obstructive Sleep Apnea (on CPAP) Social History: Retired teacher, no tobacco, infrequent alcohol Allergies: NKDA Presentation: John presents to the emergency department with complaints of palpitations, shortness of breath, mild chest discomfort, and lightheadedness for the past 6 hours