This Phase Ila trial evaluates whether the intravenous administration of Dexrazoxane can reduce permanent heart muscle damage in patients undergoing standard stent procedures (PCI) for a severe heart attack (STEMI).

Inclusion Criteria -

1. Adult (18 - 79 years).
2. First STEMI (EMS/ER ECG ST-elevation) with primary PCI planned.
3. Consent pathway available: Patient consent, Legally Acceptable Representative (LAR)
4. CMR likely be feasible (no known MRI-unsafe implant or absolute MRI prohibition)

Exclusion Criteria -

1. History of PCI or CABG within 1 year
2. Known dialysis/ESRD
3. Known pre-existing LVEF <40% from recent records
4. Known pregnancy or breastfeeding (history or clearly documented)
5. Current anthracycline chemotherapy or active chest radiation (per patient/chart).
6. On iron chelation now or documented iron-storage disease (hemochromatosis/thalassemia).
7. Concurrent trials: investigational drug or device use within 90 days.
8. Any clinically significant condition identified that would preclude safe peri-procedural administration of Dexrazoxane or completion of core protocol procedures.