Following a routine cardiolite stress test that revealed a fixed apical and inferior-lateral defect, the patient experienced atrial fibrillation/flutter with a rapid ventricular response. Subsequently, he was started on amiodarone, 200 mg/d, after a 3-day loading dose of 400 mg tid. Approximately 3 months later, the patient acquired some very mild dyspnea for which he did not seek medical attention. He subsequently fell while on a boat, suffering only a minor left chest wall bruise. The patient did not have any chest pain (except for mild point tenderness at the site of the bruise), orthopnea, paroxysmal nocturnal dyspnea, or edema. No environmental exposures could be elicited. The patient denied fevers, chills, night sweats, sick contacts, changes in weight, cough, sputum production, hemoptysis, history of tuberculosis, recent travel to areas endemic for histoplasmosis or coccidiomycosis, history of malignancy, illicit drug use, or known inhalation injury. He had not made any other recent changes to his medications, which included furosemide (stable dose), lanoxin, aspirin, pravastatin, and a multivitamin.