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Cardiogenic shock is a state of tissue hypoperfusion that involves signs of progressive tissue injury due to failing heart function. Cardiogenic shock can develop as a consequence of myocardial disease/injury, valve disease or heart rhythm disturbances. Most commonly, cardiogenic shock is a complication of acute myocardial infarction. Due to improved medical managment of advanced heart failure and methods of urgent reperfusion of culprit coronary arteries, the incidence of cardiogenic shock and its mortality have declined in the last decade. However, about a half of patients with cardiogenic shock still die. The diagnosis of cardiogenic shock is much more challenging than it seems. It is paramount that it is established quickly since timely intensive supportive and etiologic treatment significantly impacts survival in patients with cardiogenic shock.