Question

A 70-year-old man with known ischaemic cardiomyopathy presents to the emergency department with acute severe dyspnoea, orthopnoea and frothy pink sputum. He is tachypnoeic, hypertensive at 190/110 mmHg, with widespread crackles to the lung apices and oxygen saturation of 88% on room air. Which immediate intervention is most appropriate?

Accepted Answer

Sit him upright, give high-flow oxygen and commence sublingual then intravenous glyceryl trinitrate

Answer

Lay him flat and give a 1 L bolus of normal saline

Answer

Start a morphine infusion and avoid vasodilators

Answer

Delay treatment while obtaining a CT pulmonary angiogram

Answer

Cease all vasodilators and start a noradrenaline infusion

Practice question