skip to main content

Pulmonary hypertension crisis — SCE Acute Medicine MCQ

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

ModerateAcute Cardiac PresentationsPulmonary hypertension crisisSCE Acute Medicine

A 82-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 right ventricular failure in known pulmonary arterial hypertension. What is the most appropriate next step in management?

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

Reveal the answer and explanation

Correct answer: D — Seek urgent pulmonary hypertension specialist and critical care input

The key discriminator is that right ventricular failure in known pulmonary arterial hypertension, which makes Seek urgent pulmonary hypertension specialist and critical care input the single best answer. Start anticoagulation after assessing bleeding risk 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 Arrange urgent CT imaging 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/ERS pulmonary hypertension guideline