A 48-year-old woman on ICU develops an ECG showing ST elevation in V1-V4 and new right bundle branch block with haemodynamic instability. Bedside echo...

Question

A 48-year-old woman on ICU develops an ECG showing ST elevation in V1-V4 and new right bundle branch block with haemodynamic instability. Bedside echocardiography shows a severely dilated, hypokinetic RV with interventricular septal bowing. LV size and function appear normal. What is the most likely diagnosis?

Accepted Answer

Massive pulmonary embolism with acute right heart failure - the pseudo-STEMI ECG pattern (right heart strain with ST elevation in V1-V4 and RBBB) combined with isolated RV failure on echo points to PE rather than coronary occlusion

Answer

Anterior STEMI with LV failure

Answer

Pericarditis

Answer

Takotsubo cardiomyopathy

Answer

Aortic dissection

uk-fficm MCQ (SBA): Massive PE vs Anterior STEMI