MI

So I had this seemingly normalish looking patient with chest pain, vitals stable, EKG normal, short of breath and pain 9/10. This was the man that never goes to the doctors and he had pain for about a week now. I got him into the room quick, assessed and placed his line... I awaited further orders. I noticed he was slowly getting more hypertensive and tachycardic and I placed another large bore iv notified the doc. A while later he was on a nitro drip and pain was better. The patient became more short of breath and severely diaphoretic. Troponins were very elevated. This guy was having a non stemi MI. The patient went into flash pulmonary edema and had to be intubated. I was greatly challenged that night and started him on an heparin drip, integrelin, continued nitro drip and with all this he ended up needing neo to keep his pressure up. It was a continued task titrating the diprivan and nitro with effects from heparin etc. I transported this patient to icu with a rolling pole full of pumps with high risk drugs infusing, his bed and respiratory with the portable vent. He left the ER alive. Some patients I want to follow up on, he was one of them but I didn't. Everyday it's a new challenge, new patient in the Er.... That was a scary night.