Mechanical Circulatory Support Weaning With Angiotensin ReceptoreNeprilysin Inhibitor in Cardiogenic Shock

This case highlights the potent afterload-reducing effect of an intra-aortic balloon pump (IABP) in acute heart failure with reduced ejection fraction (AHFrEF). AHFrEF is characterised by prominent afterload sensitivity, and IABP removal may precipitate pulmonary edema and cardiogenic shock even after adequate decongestion; angiotensin receptoreneprilysin inhibitor initiation during IABP support may bridge toward IABP weaning in such afterload-sensitive patients.