The patient arrived in cardiac arrest. He had been brought to our emergency department in the middle of the night. Although he had a significant cardiac history, including bypass surgery, he was only in his late 40s. His transport from his house to our department had been less than 10 minutes, and the pre-hospital team had done an excellent job of intubating this patient and establishing an IV to begin resuscitation efforts. His wife was with him. Less than 15 short minutes before their arrival, her life had been altered forever when her husband had woken her from her deep sleep to complain that he had intense chest pain. Mere seconds later, she witnessed him pass out and become completely unresponsive.