Hypertensive pulmonary oedema — RCPSC EM MCQ
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Correct answer: B — Use oxygen and non-invasive ventilation with nitrate vasodilation under monitoring
The best answer is “Use oxygen and non-invasive ventilation with nitrate vasodilation under monitoring”. This is hypertensive acute pulmonary oedema. In a suitable, cooperative patient, oxygen support, non-invasive ventilation and early nitrate vasodilation rapidly address respiratory distress and excessive afterload; diuretics may also be used after initial assessment. Fluids, inotropes, morphine-first management and acute beta-blockade do not match the perfusing hypertensive phenotype.
Reference: Emergency Care BC: Acute Heart Failure—Management: https://emergencycarebc.ca/clinical_resource/clinical-summary/acute-heart-failure-management/