Shock and anterior myocardial infarction: beyond the initial clinical evidence.

Cardiogenic shock is a state of inadequate tissue perfusion due to cardiac dysfunction, most commonly caused by acute myocardial infarction. Mortality rates for patients with cardiogenic shock remain frustratingly high, ranging from 50% to 80%. This high mortality can be counteracted by urgent revascularization and these patients benefit from a prompt invasive procedure. We present an unusual case of a patient admitted for an acute anterior infarction and presumable subsequent cardiogenic shock. The urgent coronary angiography revealed an acute stent thrombosis in the anterior descending coronary artery, but the aortography showed that the original cause of shock was actually an abdominal aneurysm rupture. The stent thrombosis and acute anterior infarction were in fact a complication of a hypoperfusion state due to hypovolemic shock.