Question: A 58-year-old woman presented with multiple episodes of coffee ground emesis with no associated melena or hematochezia. The patient reported no prior history of gastrointestinal bleeding. She had multiple medical comorbidities, including hypertension, tobacco dependence, chronic obstructive pulmonary disease, and paroxysmal atrial fibrillation. She is currently off anticoagulant medication owing to noncompliance and a history of recurrent falls. She does take 81 mg of aspirin daily. On admission, she was hemodynamically stable except for irregular heart rhythm.