skip to main content

Inferior STEMI with right ventricular infarction — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

EasyCardiovascular medicineInferior STEMI with right ventricular infarctionSCE Acute Medicine

A 63-year-old man presents with 90 minutes of chest pain, diaphoresis and nausea. ECG shows 2 mm ST elevation in II, III and aVF with ST depression in I and aVL; blood pressure is 86/58 mmHg and JVP is elevated, with clear lung fields. The nearest PCI centre can accept him immediately. What is the most appropriate next step in management?

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

Reveal the answer and explanation

Correct answer: A — Activate primary PCI and give cautious intravenous fluid for suspected right ventricular infarction

Inferior STEMI with hypotension, raised JVP and clear lungs suggests right ventricular involvement, where nitrates and diuretics may worsen preload-dependent shock. Primary PCI is the preferred reperfusion strategy when available in a timely fashion. Cautious fluid boluses can support preload while arranging definitive reperfusion.

Reference: NICE NG185 acute coronary syndromes