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We describe a rare case of isolated right ventricular inferior free-wall rupture and cardiogenic shock caused by occlusion of the distal left circumflex coronary artery. Our case highlights the central role of transthoracic echocardiography in identifying unexpected conditions that can guide management - in our case involving early surgical intervention, thus leading to favourable patient outcomes. Coronary artery disease (CAD) is an ischemic condition that occurs as a result of partial or complete interruption of blood flow by narrowin