Cardiogenic shock usually is the result of marked depression in myocardial function. Rapid recognition and stabilization are essential if the patient is to survive. A variety of cardiovascular conditions can lead to cardiogenic shock; the most common of these is acute myocardial infarction. Once stabilization of the cardiogenic shock patient has been effected, hemodynamic monitoring and definitive therapy should be attempted if appropriate. Intra-aortic balloon counterpulsation is effective in stabilizing these patients temporarily. Definitive therapy may include surgical or catheterization interventions. Mortality, even under the best of circumstances, remains high.