With a diagnosis of Killip class IV anterior subacute myocardial infarction, the patient underwent emergent coronary angiography, which revealed chronic occlusion of distal circumflex artery and acute occlusion of proximal anterior descending artery (Figure). This led to implantation of a stent in anterior descending artery. Given his persistent instability, he underwent implantation of a left ventricular assist device, which resulted in an initial improvement, although he was unable to tolerate weaning. One week later, he was placed on the waiting list for cardiac transplantation. The outcome of the intervention was satisfactory and he was stable and asymptomatic at the time of discharge.

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