The purpose of this article is to describe a nursing experience in a patient having AMI and 3rd degree A-V block who had cardiogenic shock, dyspnea and anxiety in the emergency department. The authors assessed the patient's health condition by Roy's adaptation model at 09:16 to 10:40, March 12, 2006. Three nursing problems were identified as follows: Insufficiency of tissue perfusion-cardiac and pulmonary, disturbance of gas exchange and anxiety. During the nursing process, the authors stabilized the patient's vital signs to accept PCI as soon as possible. Mental support was given to release anxiety by listening, explaining and empathy. From this experience, it can be seen that emergency nursing care for a patient with AMI and 3rd degree A-V block can be effective in assisting emergency crisis and avoiding treatment delays.