Sandeep Nathan, MD, MSc, discusses key aspects of managing acute myocardial infarction cardiogenic shock (AMICS) within the first 12 hours. He gave this presentation in June 2023 at the Cardiogenic Shock Working Group (CSWG) Global Summit. Dr. Nathan focuses on the management of cardiogenic shock in level one tertiary/quaternary programs. He describes the chain of communication with the Shock Team and protocols for managing AMICS, including an algorithm from the National Cardiogenic Shock Initiative (NCSI) and the protocol used at the University of Chicago Medicine (UCM). He concludes that initial management of AMICS requires coordination, multidisciplinary input, and protocol-driven care, with revascularization and stabilization occurring within the first three hours and discussion of escalation and exit strategies occurring within the first six to 12 hours.