skip to main content

Symptomatic severe aortic stenosis — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateAcute Cardiac PresentationsSymptomatic severe aortic stenosisSCE Acute Medicine

A 29-year-old man presents with acute chest symptoms with haemodynamic concern. Relevant history includes cardiovascular risk factors or structural heart disease. On assessment, haemodynamic findings and ECG changes are present. Investigations show exertional syncope with valve area 0.7 cm2 and high gradient. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Symptomatic severe aortic stenosis

The key discriminator is that exertional syncope with valve area 0.7 cm2 and high gradient, which makes Symptomatic severe aortic stenosis the single best answer. Aortic dissection is less appropriate because it does not address the dominant acute risk in the vignette; Acute coronary syndrome would fit a different presentation or later stage of care. Vasculitic pulmonary-renal syndrome and Acute kidney injury are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: https://www.nice.org.uk/guidance#acute-medicine-order-24-1