It was all loooking so simple for Nadal early on in New York, with the 33-year-old racing in to a two-set lead. But his Russian opponent was not prepared to lie down in his first major final and roared back to 2-2.
Finally, in a match that lasted 4 hours and 50 minutes, Nadal's superior experience told and a 7-5, 6-3, 5-7, 4-6, 6-4 win secured him a second major title of the season, following his French Open win.
"This victory means a lot," Nadal said after the match. "And the way it happened. It was hard to control the nerves. The nerves were so high after having the match almost under control."
The world No. 2 took the top prize of $3.85 million (€3.5 million) at Arthur Ashe Stadium and added to his US Open trophy haul from 2010, 2013 and 2017.
In addition to nearing Federer's mark, with the Swiss player five years his senior, Nadal moved one title short of the Open era record of five US Open titles won by Federer, Jimmy Connors and Pete Sampras.
"A 19th Grand Slam title is something unbelievable, outrageous," Medvedev said, paying tribute to his opponent.
Nadal's win now means that he, Federer and Novak Djokovic have shared the last 12 men's Grand Slam titles between them, with Stan Wawrinka's US Open win in 2016 the last time the monopoly was broken.
mp/pfd (Reuters, AFP)