Question: A 76-year-old man presented to the emergency department complaining of exertional dyspnea in the previous 3 weeks and an episode of presyncope that day. He denied orthopnea, paroxysmal nocturnal dyspnea, and precordial pain. On further questioning, the patient revealed a 3-week history of melena. He denied hematemesis, hematochezia, hematuria, or any other macroscopic blood loss. Physical examination was unremarkable except for mucocutaneous pallor. Electrocardiography was normal. Bloodwork revealed a low hemoglobin of 6.7 g/dL, normal high-sensitivity troponin I, and low B-type natriuretic peptide.