An unusual cause of cardiogenic shock. How would I approach it?

HOW WOULD I APPROACH IT? The authors hereby present the clinical case of a 61-year-old male who suffered a seizure in his home, was assessed by the EMT, and then transferred to his reference center where one primary angioplasty was performed with a diagnosis of inferior-lateral ST-segment elevation acute myocardial infarction in a situation of cardiogenic shock (CS) and further treatment with vasoactive amines and orotracheal intubation. Upon arrival to the cath. lab and since the CS was persistent, as a first-line therapy, it was decided to implant the circulatory mechanical assist Impella CP device (AbioMed, Danvers, Massachusetts, United States). Then a coronary angiography confirmed the embolic occlusion of the circumflex and right coronary arteries that resolved partially after thrombus aspiration and simple angioplasty. However, since hemodynamic instability was persistent and a left intracavitary mass was found on the echocardiography after the interventional procedure, it was decided to remove the Impella CP device and proceed to use extracorporeal membrane oxygenation (ECMO).