A56-year-old male with a history of hypertension and coronary disease was admitted after complaining of mild shortness of breath and palpitations. He had undergone coronary bypass surgery 4 years prior to admission and had been followed regularly by his physicians. His resting heart rate at his last office visit B6 months before was 58/min and his hypertensive regimen, consisting of lisinopril only, was recently intensified. He had been under severe stress recently and had not been eating well. His caffeine intake was limited to one large coffee daily. (Published: 18 July 2011) Citation: Journal of Community Hospital Internal Medicine Perspectives 2011, 1 : 7241 - DOI: 10.3402/jchimp.v1i2.7241