FCP(SA) Part II Practice Questions - Fellowship Of The College Of Physicians Of South Africa Part II Exam

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A 62-year-old male presents 5 days after an anterior ST-elevation myocardial infarction with sudden hemodynamic deterioration, dyspnea, and a new harsh holosystolic murmur heard loudest at the lower left sternal border with an associated parasternal thrill. Oxygen saturation drops from a right atrial sample of 65% to a right ventricular sample of 84% during bedside pulmonary artery catheterization. Which of the following is the most definitive immediate management strategy?

Urgent surgical repair or transcatheter closure with intra-aortic balloon pump stabilization Emergent bed-side pericardiocentesis and bolus fluid administration Urgent mitral valve replacement with coronary artery bypass grafting Immediate intravenous thrombolysis with tenecteplase and systemic heparinization

Correct Answer:

Urgent surgical repair or transcatheter closure with intra-aortic balloon pump stabilization

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