Myocarditis — MCCQE Part 1 MCQ

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ModerateChest PainMyocarditisMCCQE Part 1

A 23-year-old man has chest pain and dyspnoea 1 week after a viral illness; troponin is elevated, coronary CT is normal and cardiac MRI shows myocardial oedema. Which of the following is the most likely diagnosis?

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Correct answer: E — Myocarditis

Myocarditis is the single best answer because the age, timing, examination findings and investigations in the vignette fit Myocarditis better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to CCS myocarditis guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: CCS myocarditis guidance