Case Presentation: We present the case of a 32-year-old woman with past medical history of anxiety/depression, previous heroin abuse, hepatitis C who presented with tremors, chest pain, and vomiting. In the ER, her vitals were HR 94, RR 22, BP 117/83, SpO2 95% on room air. Initial labs showed elevated troponin 1.38, 4.44, 9.15. EKG [...]