An 82-year-old woman with a history of coronary artery bypass grafting (CABG; left internal mammary artery [LIMA] to left anterior descending [LAD] artery, saphenous vein graft [SVG] to obtuse marginal [OM], SVG to right coronary artery [RCA]) 24 years before presentation, abdominal aortic aneurysm repair 5 years before presentation that was complicated by endoleak requiring endovascular repair 3 years before presentation, known SVG-OM aneurysm two years previously (measuring 4.5 × 2.8 cm), hypertension, carotid artery stenosis, recurrent pulmonary embolism requiring anticoagulation, and iron deficiency anemia presented with worsening angina and dyspnea that had been ongoing for one month.