On November 29, 2012, American 1167 heavy, a Boeing 767-323ER, departed from MIA at 0945 bound for POS, right on schedule. It was "smooth flying" until we got over the Bahamas... At around 34,000 feet, a gentleman on board had a heart attack. We immediately turned around and started heading back to MIA for an emergency landing. We climbed to 35,000 feet and once we were over Florida, we began a pretty fast descent. The pilots pulled the power all the way back, extended the spoilers/speedbrakes, and pitched down like 5 degrees. In a matter of minutes we were at less than 3,000 feet and were right next to MIA. We did a close traffic pattern to runway 9, which is like the first time I've ever seen a widebody jet do one that small. Our approach was high and fast, and we landed hard and fast. Then we taxied off the runway, bla bla bla, dropped off the guy (who was feeling a little better), then we took off again. The crew really handled the emergency nicely. 3.3 hours later, we landed at POS in Trinidad. More info here: http://flightaware.com/live/flight/AAL1167/history/20121129/1445Z/KMIA/TTPP This picture is of the west coast of Trinidad on our approach to POS.