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Myocarditis with ventricular arrhythmia — SCE Acute Medicine MCQ

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ModerateAcute Cardiac PresentationsMyocarditis with ventricular arrhythmiaSCE Acute Medicine

A 63-year-old woman 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 LV dysfunction with runs of non-sustained VT after viral illness. What is the most appropriate next step in management?

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Correct answer: B — Admit to monitored coronary care or critical care with cardiology input

The key discriminator is that LV dysfunction with runs of non-sustained VT after viral illness, which makes Admit to monitored coronary care or critical care with cardiology input the single best answer. Optimise chronic medication and discharge is less appropriate because it does not address the dominant acute risk in the vignette; Give analgesia and antiemetic therapy would fit a different presentation or later stage of care. Give intravenous fluids with reassessment and Call critical care for escalation 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: ESC myocarditis guidance