A 57-year-old male patient was admitted to the emergency department of a small hospital with complaints of chest pain and palpitation. He was found to be hypotensive with inferior wall STEMI, pulmonary edema, and a low ejection fraction of 30%. The patient was initially given NIV but was later intubated and put on invasive ventilation. The hospital did not have a Cardiac Cath lab. The cardiologist resuscitated the patient and administered thrombolysis. The patient was subsequently sent to a higher center for PCI interventions and further care. The patient was on 10 ml/h of noradrenaline infusion and ventilatory support. He was shifted to an ACLS ambulance.