Cardiogenic Shock (SCAI Stage D) Following Pharmacological Reperfusion of Anterior ST-Segment Elevation Myocardial Infarction in a Young Woman: A Case Report

Cardiogenic shock remains the leading cause of mortality in patients with ST-segment elevation myocardial infarction, typically occurring in older individuals with established cardiovascular disease. However, severe hemodynamic deterioration may also develop in younger patients outside the expected epidemiological profile. We report the case of a 39-year-old woman who presented with an anterior ST-segment elevation myocardial infarction and subsequently developed cardiogenic shock following pharmacological reperfusion. Despite the absence of traditional cardiovascular risk factors, the patient experienced rapid clinical deterioration requiring vasoactive and inotropic support. Electrocardiographic findings demonstrated extensive anterior and anteroseptal myocardial involvement, highlighting infarct size and location as key determinants of shock severity. The clinical course illustrated the dynamic nature of cardiogenic shock, which evolved during hospitalization rather than at initial presentation. Application of the Society for Cardiovascular Angiography and Interventions (SCAI) classification provided a useful framework for early recognition and management escalation. This case emphasizes that younger age does not preclude the development of cardiogenic shock and underscores the importance of close post-reperfusion monitoring and physiology-oriented clinical assessment beyond age-based risk stratification.