Cardiogenic shock (CS) is a clinical condition characterized by profound depression of myocardial contractility resulting in inadequate cardiac output and end-organ hypoperfusion often complicated by a systemic inflammatory response, hypoxia, and cellular and metabolic derangements [ , ]. Clinically it is defined by hypotension refractory to volume resuscitation, oxygenation, ventilation, and pharmacotherapies including vasopressor and inotropic support. Approximately three-fourths of CS cases occur due to acute myocardial infarction (AMI), and most of the remainder are caused by acute decompensated heart failure [ , ]. Mortality from AMI-related cardiogenic shock (AMICS) remains high, around 50 %, despite early revascularization and technological advances, especially with regard to mechanical circulatory support (MCS) devices. These devices provide a wide range of hemodynamic and metabolic benefits in severe refractory CS. Key mechanisms by which these devices provide support include reduction in intracardiac filling pressures, ventricular volumes, wall stress, and oxygen consumption, maintaining circulation and augmenting end-organ perfusion, as well as limiting the final infarct size [ , ]. The most commonly utilized devices include intra-aortic balloon pump (IABP), axial flow pumps (Impella CP and Impella 5.5, Abiomed, Inc., Danvers, Massachusetts), left atrial-to-femoral arterial ventricular assist devices (TandemHeart, LivaNova PLC, London, United Kingdom), and venous-arterial extracorporeal membrane oxygenation (VA-ECMO).