Case Presentation: A 57-year-old incarcerated male with end stage renal disease (ESRD) on hemodialysis, coronary artery disease (CAD), and Gastroesophageal reflux disease (GERD) presented to the emergency department with several episodes of hematemesis, shortness of breath and fatigue for the past 2 days without any associated abdominal pain, dysphagia, or odynophagia. On exam, he was [...]