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Myocarditis — SCE Acute Medicine MCQ

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HardAcute Cardiac PresentationsMyocarditisSCE Acute Medicine

A 27-year-old woman is assessed on the acute medical unit. She has chest pain, fever and palpitations one week after influenza-like illness. Troponin is raised, coronary CT is normal and cardiac MRI shows myocardial oedema. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: C — Acute myocarditis

Acute myocarditis is the best answer because troponin rise with viral prodrome and non-ischaemic imaging pattern is most consistent with myocarditis. Neutropenic sepsis is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Myocarditis can mimic acute coronary syndrome in younger adults.

Reference: https://www.nice.org.uk/guidance#acute-medicine-order-92-1