This 84-year-old man with a history of coronary artery disease presents with 2 days of melena and black colored emesis. Stools becoming less dark, but he had increased lethargy and presented to the emergency department today.  Initial systolic blood pressure recorded in the 60s,  but all in 110-120s after that.  In the ED, he had gastric lavage with coffee ground emesis that cleared with 600 cc of flushing. During the lavage he had chest pressure with mild ST depression V3-V5 that resolved spontaneously.  Patient is on ASPIRIN 81 mg Tablet by mouth daily.