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Hypertensive acute pulmonary oedema — RCPSC EM MCQ

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HardCardiovascular emergenciesHypertensive acute pulmonary oedemaRCPSC EM

A 79-year-old woman is brought in with severe dyspnoea, diaphoresis, and frothy sputum. Blood pressure is 224/118 mmHg, respiratory rate 34/min, oxygen saturation 82% on a non-rebreather, and lung ultrasound shows diffuse B-lines. ECG shows sinus tachycardia without STEMI. What is the most likely diagnosis?

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Correct answer: E — Hypertensive acute pulmonary oedema

Severe hypertension, frothy sputum, hypoxaemia, and diffuse B-lines indicate hypertensive acute pulmonary oedema. Management centres on non-invasive ventilation and nitrates.

Reference: CAEP Acute Heart Failure Best Practices Checklist; CCS heart failure guidance