In this case, students will be caring for a patient with decompensated heart failure, which will progress to cardiogenic shock. Students will need to recognize this acute decompensation in clinical status through progression of unstable vital signs and EKG results. They will then need to order and interpret the correct diagnostic laboratory and imaging testing, which will show the cause of the patient’s cardiogenic shock. They will need to treat the patient with the appropriate supportive medication in the cardiac intensive care unit. Proper completion of the case and understanding of the learning objectives should allow students to gain a better understanding of cardiac physiology and the pathology that results in cardiogenic shock, as well as appropriate workup and management in this life-threatening scenario.