Case Presentation A 73-year-old male with a past medical history significant for hypertension, prior acute kidney injury, and benign prostatic hyperplasia managed with tamsulosin. Presenting Complaints Sudden-onset severe left flank pain Multiple episodes of vomiting Intermittent dizziness No dysuria, hematuria, or fever Initial Vital Signs Blood pressure: 210/114 mmHg Heart rate: 88 bpm Oxygen saturation: 98% on room air   Physical Examination Marked left flank tenderness No peritoneal signs Cardiovascular and respiratory examinations unremarkable  Laboratory Findings Leukocytosis: 12.9 × 10⁹/L Elevated creatinine: 2 mg/dL HbA1c: 6.6% Urinalysis: 2+ protein, trace hematuria, no pyuria Elevated homocysteine (16.1 µmol/L) Low antithrombin III (74%) Positive lupus anticoagulant (interpreted cautiously due to heparin use) Electrocardiography Initial ECG: Normal sinus rhythm No ischemic…