Should Medvedev defeat the Spanish great, he will become the first man in the Open era to win his first two Grand Slam titles in succession after his triumph in New York last September.
The Russian denied Novak Djokovic the calendar Grand Slam in the U.S. Open final and will now seek to stop Nadal from setting an all-time men's record of 21 Grand Slam titles.
Medvedev lost his temper late in the second set against Tsitsipas, accusing his rival of being coached by his father from the sidelines - which is against the rules.
"To be honest, I don't think that emotions helped me too much," the Russian said on court.
"You lose concentration and too much energy. As soon as I did it, I (thought), 'That is a big mistake'. I am happy I (regained) concentration at the beginning of the third set.
"I managed to pull out some serves and it brought me back into the match."
Medvedev was also mindful of the importance of Sunday's final in the broader context as to which of the Big Three -- Nadal, Djokovic and Roger Federer -- will become the most successful man in history.
His defeat of Djokovic in New York last September denied the Serbian a chance to move ahead of Nadal and Roger on the all-time list, leaving all three tied on 20 major titles.
Medvedev, who lost to Nadal in five sets in the 2019 U.S. Open final, will maintain the status quo at the top if he can reverse that loss to the Spaniard.
"I will play, again, against one of the greatest. And play against someone going for their 21st Slam," he said.
"Grand Slam finals are special. Of course, I remember that match against Rafa in my first final and we played like five hours, or something close to it.
"We have played a few matches since then and I am ready. I know that Rafa is a very strong player. I will need to show my best to win this match."
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