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Acute cardiogenic pulmonary oedema — RCPSC EM MCQ

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HardCardiovascular emergenciesAcute cardiogenic pulmonary oedemaRCPSC EM

A 74-year-old with hypertension arrives severely breathless. BP is 218/116 mmHg, RR 34/min, oxygen saturation 82%, and auscultation reveals diffuse crackles. ECG shows sinus tachycardia; POCUS shows B-lines and reduced left ventricular function. What is the most appropriate initial management?

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

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Correct answer: C — Start non-invasive ventilation and IV nitroglycerin

Start non-invasive ventilation and IV nitroglycerin is correct: the clues indicate Acute cardiogenic pulmonary oedema and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Canadian ED heart failure practice; ACLS principles