From Struggle to Triumph: A Journey Through SCAI Stages to Myocardial Recovery

Cardiogenic shock (CS) is a time-sensitive, dynamic, and multifactorial syndrome that can progress quickly to multiorgan failure and become fatal if not addressed urgently. We present a case of a 47-year-old man who presented with non-ST-segment elevation myocardial infarction complicated by cardiogenic shock who was found to have ischemic cardiomyopathy with multivessel coronary artery disease. His clinical course was complicated by hemodynamic collapse requiring escalation of temporary mechanical circulatory support from intra-aortic balloon pump to Impella 5.5 to venoarterial extracorporeal membrane oxygenation support. Through a multidisciplinary team-based approach, he was successfully resuscitated, bridged to myocardial recovery, and discharged home with close follow-up in a multidisciplinary postshock clinic. This case underscores the importance of a multidisciplinary shock team approach to evaluation and management of patients with cardiogenic shock and various complications in both inpatient and outpatient settings as a bridge to myocardial recovery.