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Cardiogenic shock after MI — ABEM Board MCQ

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HardCardiovascular emergenciesCardiogenic shock after MIABEM Board

A 63-year-old woman with anterior STEMI becomes progressively hypotensive in the ED. Triage acuity is ESI 1; BP 72/44 mm Hg, HR 118/min, cool extremities, crackles, and altered mentation. Bedside echo shows severe LV systolic dysfunction without tamponade. Norepinephrine is being prepared. Which of the following is the most important immediate intervention?

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

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Correct answer: C — Arrange emergent coronary angiography with revascularization

Cardiogenic shock complicating MI requires vasopressor support and urgent revascularization; delaying reperfusion worsens mortality.

Reference: AHA/ACC ACS guidance; AHA ACLS post-arrest and shock guidance