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Right ventricular infarction — RCPSC EM MCQ

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HardCardiovascular emergenciesRight ventricular infarctionRCPSC EM

An ambulance brings a 66-year-old with 90 minutes of crushing chest pain, diaphoresis, and nausea. Triage ECG shows inferior ST elevation with ST elevation in V4R. Blood pressure is 82/54 mmHg, lungs are clear, and the patient took sildenafil the previous evening. What is the most likely diagnosis?

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

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Correct answer: B — Right ventricular myocardial infarction

Right ventricular myocardial infarction is correct: the clues indicate Right ventricular infarction and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: ACLS principles; Canadian STEMI systems of care