skip to main content

Acute decompensated heart failure — ABEM Board MCQ

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

ModerateCardiovascular emergenciesAcute decompensated heart failureABEM Board

A 76-year-old man with heart failure arrives with severe dyspnea and frothy sputum. Triage acuity is ESI 2; BP 188/102 mm Hg, HR 118/min, RR 32/min, SpO2 84% on room air. He has diffuse crackles, JVD, and bilateral leg edema. Chest radiograph shows pulmonary edema. Which of the following 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: E — Start noninvasive positive-pressure ventilation and IV nitroglycerin

Hypertensive pulmonary edema is treated with ventilatory support and vasodilation; fluids and outpatient management are unsafe.

Reference: ACEP Acute Heart Failure Syndromes clinical policy