An Elderly Man with Worsening Chest Pressure

Patient describes worsening chest pain for 2 years; also easy bruising, bleeding. Follow ED exam on video. What's your diagnosis?

An 87-y/o man is seen in the ED for severe acute chest pain. PMH: 2y of intermittent worsening chest pain at rest; PAD w/ femoral artery bypass; aortic stenosis; no known coronary disease. Easy bleeding; recent derm procedure paused for heavy bleeding. Awake, alert; no pain. Vital signs, WNL; normal ECG.

What's your diagnosis?