A 75 year-old man with no significant prior medical history was transferred to our hospital for emergent management of inferior ST-elevation myocardial infarction. He had presented to a regional hospital with acute onset shortness of breath and mid-chest pain on going for 2h prior to presentation. He was emergently transferred to our hospital for further management of Acute Coronary Syndrome (ACS). On arrival, his blood pressure was 108/71mmHg. However, he was tachycardic with a heart rate 140beats/min and hypoxemic with oxygen saturation of 84% on ambient air.