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Right ventricular myocardial infarction — RCPSC EM MCQ

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HardCardiovascular emergenciesRight ventricular myocardial infarctionRCPSC EM

A 58-year-old man is CTAS 2 with crushing chest pain and diaphoresis. ECG shows inferior ST elevation with ST elevation in V4R, blood pressure 86/58 mmHg, clear lung fields, and jugular venous distension. He took sildenafil 8 hours ago. What is the most likely diagnosis?

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Correct answer: B — Right ventricular myocardial infarction

Inferior STEMI with right-sided lead ST elevation, hypotension, raised JVP, and clear lungs is right ventricular myocardial infarction.

Reference: ACLS; Canadian Cardiovascular Society acute coronary syndrome guidance