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Acute severe mitral regurgitation after MI — RCPSC EM MCQ

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HardCardiovascular emergenciesAcute severe mitral regurgitation after MIRCPSC EM

A 72-year-old with severe dyspnoea has a new loud systolic murmur 3 days after an inferior MI. BP is 82/46, lactate 5.0, pulmonary oedema is present, and echo suggests papillary muscle rupture with severe mitral regurgitation. What is the most appropriate disposition?

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Correct answer: A — ICU admission with urgent cardiology and cardiac surgery involvement after stabilisation

Mechanical complication after MI causing cardiogenic shock requires ICU-level stabilisation and urgent definitive cardiac intervention.

Reference: CCS acute coronary syndrome guidance; Canadian cardiac critical care practice