On March 22, 2003, a 62-year-old male volunteer Fire Fighter (FF) responded to a structural fire. The FF had conducted fire suppression activities on-scene for about 29 minutes when he began complaining of difficulty breathing and fatigue. He presented himself to the on-scene ambulance, where he suddenly collapsed. Approximately 20 minutes later, despite cardiopulmonary resuscitation (CPR) and advanced life support (ALS) administered on-scene, en route, and at the hospital, the FF died. The autopsy report, completed by a pathologist, stated the FF “died of acute, occlusive thrombosis of the left circumflex coronary artery secondary to coronary artery atherosclerosis.” The physical stress of fire fighting and the underlying atherosclerotic coronary artery disease (CAD) contributed to this fire fighter’s cardiac arrest and sudden death.