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Valvular heart disease is an uncommon but high-risk cause of cardiogenic shock requiring rapid, multidisciplinary management aimed at bridging patients to definitive surgical or transcatheter valve intervention. Early comprehensive Doppler echocardiography is essential, as clinical signs may be subtle. Distinguishing decompensated chronic valvular disease from acute unstable lesions guides urgency and treatment strategy. Medical stabilization and mechanical circulatory support vary markedly between stenotic and regurgitant lesions, and standard shock therapies may be harmful in specific contexts. Transcatheter approaches are preferred when feasible, though their expanding use introduces added complexity in cardiac intensive care.