Adenosine conditioning and pacing in conjunction with early intra-aortic balloon pump use and glycoprotein IIb/IIIa inhibition to accomplish complete multivessel revascularization in an octogenarian with profound cardiogenic shock.

: This report describes the use of intracoronary adenosine and transvenous pacemaker backup as an adjunct to intra-aortic balloon pump use and glycoprotein IIb/IIIa inhibition to accomplish high-risk multivessel coronary angioplasty in an 87-year-old female with profound cardiogenic shock. Myocardial preconditioning may further enhance microvascular perfusion in this critical state.