Case Study #2

The patient is a fifty year-old man who complains of several minutes of "blacking out." He does not recall fainting or falling, but there are several minutes that he cannot remember. He denies any recent head trauma. He had a high stress job and smokes at least 2 packs of cigarettes per day. He has a known history of cardiovascular disease including a severe heart attack within the past few years.

The most likely cause of this patient’s complaint is: