A 52-year-old female with past medical history of diabetes mellitus, hypertension and chronic renal disease presented with nonischemic cardiomyopathy and left ventricular failure. On day one, an intra-aortic balloon pump (IABP) and Swan-Ganz catheter were placed uneventfully. The IABP metallic tip was positioned in the proximal descending aorta (Fig. 1).