In this in-depth analysis of the Altshock-2 trial (Study on Early Intra-aortic Balloon Pump Placement in Acute Decompensated Heart Failure Complicated by Cardiogenic Shock), Harlan M Krumholz, MD, FACC, goes deep into the study and its two related editorials. Listen here for this unique behind-the-scenes look at the review process, plus a thoughtful summary of the study and the two related editorials. All this content appears in JACC, in our special focus issue on cardiogenic shock.