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Acute myocarditis — SCE Acute Medicine MCQ

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HardAcute Cardiac PresentationsAcute myocarditisSCE Acute Medicine

A 34-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 viral prodrome, high troponin, normal coronaries and cardiac MRI oedema. What is the most likely diagnosis?

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Correct answer: C — Acute myocarditis

The key discriminator is that viral prodrome, high troponin, normal coronaries and cardiac MRI oedema, which makes Acute myocarditis the single best answer. Diabetic ketoacidosis is less appropriate because it does not address the dominant acute risk in the vignette; Toxic drug ingestion would fit a different presentation or later stage of care. Vasculitic pulmonary-renal syndrome and Anaphylaxis 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-25-1