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A 67-year-old black woman with hypertension and adult-onset diabetes mellitus presented to Hermann Hospital, Houston, Tex, with complaints of intermittent chest pain and shortness of breath. She stated that 5 days before presentation she had begun walking for exercise, starting with one block, and increasing by one block daily. During the past 2 days, she noted a pressure-type pain under the left breast associated with shortness of breath after walking only two blocks. The feeling of shortness of breath increased over this time, such that she experienced three-pillow orthopnea. Thus, she presented to the emergency department. She did not have nausea, vomiting, or diaphoresis with the episodes of chest pain. She denied previous episodes of similar pain or shortness of breath. She did not experience swelling of the extremities. The patient had been treated for hypertension for many years. Adult-onset diabetes mellitus was diagnosed 5 years previously, requiring oral medication for glycemic control. There was a history of "phlebitis" in 1974 treated by surgical "vein stripping." Her family history was significant for myocardial infarction in her mother at age 64. She was widowed and lived alone. She had no history of smoking, alcohol, or intravenous drug use. Her medications included 10 mg glyburide BID, 240 mg/day sustainedrelease verapamil, and tolmetin sodium on an occasional basis. She had no known drug allergy.

Fatal ventricular fibrillation 3 days after percutaneous transluminal coronary angioplasty in a 67-year-old woman.