A 72-year-old male with no significant past medical history suffered an out-of-hospital cardiac arrest requiring multiple shocks before return of spontaneous circulation. Cardiac arrest reoccurred in the emergency department necessitating defibrillation and endotracheal intubation. Electrocardiogram demonstrated ST-elevation in the inferior leads and cardiac catheterization revealed left main and multi-vessel coronary disease. Cardiogenic shock ensued necessitating vasopressors, inotropes, and insertion of an intra-arterial balloon pump.