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Cardiogenic shock after MI — SCE Acute Medicine MCQ

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HardAcute Cardiac PresentationsCardiogenic shock after MISCE Acute Medicine

A 70-year-old man is assessed on the acute medical unit. He has anterior MI treated with PCI and remains hypotensive with cold peripheries. Lactate is 5.2 mmol/L, urine output is low and echo shows severe LV impairment. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate next step in management?

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

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Correct answer: B — Request urgent senior critical care review

Request urgent senior critical care review is the best answer because cardiogenic shock requires immediate senior multidisciplinary escalation, haemodynamic support and assessment for mechanical complications. Arrange same-day ambulatory follow-up 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: Diuretics alone may worsen perfusion in true shock.

Reference: https://www.nice.org.uk/guidance/cg187#acute-medicine-order-62-1