patient 68 yrs old male, liver transplant x 11 yrs, diabetes, COPD has passed out 2-3 times in past 2 months - last night about 15 mins after hot shower, got up from chair & stood at bathroom door expelling loud gas, then knees buckled & passed out - no memory since sitting in chair, no fever, no pain (earlier in day reported right tummy pain followed by diarheah) - extremely low BP after event (63/48) which became normal over the next hour.