84 year-old man with CAD s/p CABG, DM, HTN, presented with 2 days of
   black stools and coffee ground emesis.  Pt reports of woke up 2am on
   [**10-19**] and had black soft/loose BM, followed by nausea and and vomiting
   blackish liquid.  He felt better but continued to have three more black
   stools over the next two days.  He vomited a total of [**1-20**] times before
   presenting to the hospital.  He has been feeling lethargic and
   lightheaded and called the ambulence at the advice of his son.  His
   stools were lightening in color prior arriving.  He has not been using
   any new medications and has not had a prior GIB.
   .
   In the ED, initial VS: 98.7 88 65/47 98%/RA.  He was BIBEMS with SBPs
   110-120s and has had similarly stable blood pressures since arrival.
   He had an NG lavage with coffee ground emesis that cleared with 600 cc
   of flushing.  During the lavage he had chest pressure and an EKG showed
   STD in V2-4.  He did not have radiation, pain, or diaphoresis.  
   
   Home medications:
   ALLOPURINOL 300 mg Tablet by mouth daily
   GLIPIZIDE 5 mg Extended Rel by mouth daily
   LOSARTAN [COZAAR]  100 mg by mouth daily
   METFORMIN 500 mg by mouth daily
   METOPROLOL TARTRATE 50 mg by mouth daily
   PIOGLITAZONE [ACTOS] 15 mg by mouth daily
   SIMVASTATIN 80 mg Tablet by mouth daily
   ASPIRIN 81 mg Tablet by mouth daily
   
   Past medical history:
   Coronary artery disease s/p triple-vessel coronary artery bypass in [**7-/2899**]
   Hypertension
   Peripheral arterial disease
   Hypercholesterolemia
   Diabetes
   Osteoarthritis
   Gout
   Anemia Baseline 32-35 with unrevealing w/u by heme
   Right hernia repair in [**2877**]
   Appendectomy in [**2841**]
   Prostate disease
   N/C
   Occupation: Retired trial lawyer
   Drugs: Denies
   Tobacco: Denies
   Alcohol: Occasional