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Cardiogenic shock — SCE Acute Medicine MCQ

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ModerateAcute Cardiac PresentationsCardiogenic shockSCE Acute Medicine

A 67-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 cold peripheries, pulmonary oedema, rising creatinine and high lactate. What is the most appropriate next step in management?

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Correct answer: A — Call critical care and cardiology for inotrope-supported management

The key discriminator is that cold peripheries, pulmonary oedema, rising creatinine and high lactate, which makes Call critical care and cardiology for inotrope-supported management the single best answer. Give analgesia and antiemetic therapy is less appropriate because it does not address the dominant acute risk in the vignette; Give controlled oxygen and senior review would fit a different presentation or later stage of care. Arrange urgent specialist referral and Provide supportive care and close monitoring 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: NICE acute heart failure guidance