This case involves a seventy-four-year-old male, with a history significant for BPH, that presented to the emergency room after a syncopal episode. The patient also complained of upper back pain that was thought to be associated with rigorous physical activity the past few days. The patient reported becoming dizzy and sweating while lying in bed. He thought he was having a heart attack, but when he got up to take an aspirin, he passed out for a few minutes. The patient denied chest pain or shortness of breath on arrival, but did feel nauseous and vomited two times before coming to the hospital. While in the ER, the patient started to complain of right shoulder blade pain traveling to the front of his chest towards the neck. The patient was not worked up with the standard diagnostic tests for an aortic dissection or abnormal heart rhythms. Only a chest X-ray, EKG, and cardiac enzymes were ordered as part of a brief cardiac workup. The EKG showed a prolonged QT wave and also inverted T waves. The patient was admitted to the internal medicine floor for observation and within four hours of his admission, the patient sustained another syncopal episode while trying to ambulate. The patient was found by nursing staff and a code blue was called. CPR protocol was initiated but the patient was unable to be revived.