Sarkis Kiramijyan, MD, FACC, FSCAI, presents an Impella RP case study highlighting early identification and rapid intervention. The patient is a 77-year-old female who decompensated three hours after admission to the ICU following cardiac surgery. She was in robust right ventricular failure and cardiogenic shock. Dr. Kiramijyan placed the patient on Impella RP support via right femoral venous access to address acute RCA occlusion likely caused by plaque disruption during surgical intervention on the aortic root. Dr. Kiramijyan discusses Impella RP weaning and the course of the patient’s recovery. Dr. Kiramijyan is an interventional cardiologist and structural heart disease specialist at Adventist Health in Los Angeles.