Doh! Alright... have you made SH4 large address aware? Also, were your DPI settings at 150% back when it worked? Did you do any tweaking with the graphics control panel since it worked?
Are you playing on a laptop and is it in power saver mode? Or have onboard graphics enabled? Finally, I think a multi-monitor set up kept my game from being able to run: It would run in clone mode but not with the desktop extended.
That's all I can think of right now. When you do figure it out please let us know. By the way, don't feel any obligation to provide me answers to these questions; you're the one troubleshooting. I'm just hoping to point you in the right direction. Best of luck.
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