Tara Hrobowski-Blackman, MD, presents the case of a 22-year-old female with a history of paroxysmal supraventricular tachycardia (PSVT) who is 40 weeks pregnant when she presents. During more than 40 days of hospitalization, the patient receives mechanical circulatory support (MCS) from Impella CP®, VA ECMO, VV ECMO, ECpella, and ultimately a durable LVAD. In addition to a detailed presentation of this case, Dr. Hrobowski-Blackman touches on the issue of racial disparities in cardiovascular outcomes.