Background High-risk patients with coronary heart disease who develop acute myocardial infarction (AMI) have severe coronary lesions. If severe complications occur, such as malignant ventricular arrhythmia, cardiogenic shock, and cardiac arrest, implementation of emergency percutaneous coronary intervention (PCI) may be hindered, leading to a higher perioperative mortality rate. Extracorporeal membrane oxygenation (ECMO) can pave the way for rapid myocardial reperfusion therapy. When cardiac arrest occurs, hemodynamic support with ECMO can facilitate revascularization with PCI, which can increase the time available for further salvage and treatment and reduce intraoperative risk during PCI. Case presentation Herein, we report a case of a 61-year-old man with AMI who suffered electrical storm of sustained malignant ventricular fibrillation, cardiogenic shock, and cardiac arrest and was successfully treated with PCI with ECMO support. During PCI, repeated aspiration and removal of the right coronary artery thrombus were performed, and blood flow was restored after right coronary artery balloon dilation. One episode of defibrillation was delivered to restore sinus rhythm. Then, stents were implanted in the distal and proximal right coronary artery lesions to achieve revascularization. After PCI with ECMO support, irreversible malignant arrhythmia returned to sinus rhythm through coronary perfusion, which prevented death following unsuccessful cardiopulmonary resuscitation. After applying active treatments, including anti-shock, mechanical ventilation, anti-inflammation, and organ support, the patient was discharged after his condition and vital signs stabilized. The patient was followed up once a week after hospital discharge, and his cardiopulmonary function recovered well. Conclusions With ECMO support, PCI should be performed immediately in patients with inferior wall AMI complicated by electrical storm of sustained ventricular fibrillation, cardiogenic shock, and cardiac arrest to facilitate stent placement, achieve complete revascularization, restore coronary perfusion, and avoid death

Background COVID-19 patients mainly have the high incidence and mortality of major cardiovascular diseases in the acute phase. However, fulminant myocarditis and cardiogenic shock are rare in the post-acute phase, and the prognosis is very poor. Case presentation Here, we report a case of a 43-year-old young man with fulminant myocarditis and cardiogenic shock in the acute phase after coronavirus infection, with timely extracorporeal membrane oxygenation and intra-aortic balloon application in respiratory failure, which improved the prognosis of fulminant myocarditis and saved the lives of COVID-19 patients. After active anti-shock, mechanical ventilation, anti-inflammation, and organ support and other treatments, the patient was discharged after a stable condition and stable vital signs. The patient was followed up weekly after discharge and showed good cardiopulmonary recovery. Conclusions In critically ill patients with severe myocarditis, cardiogenic shock, arrhythmia, respiratory and circulatory failure, ECMO and IABP in patients with explosive myocardial inflammatory cardiogenic shock have achieved better results.