A 62-year-old man with acute inferior STEMI suddenly collapses and dies within the first hour of symptom onset, before reaching hospital. What is the most likely mechanism of death?
- A Ventricular free wall rupture
- B Ventricular fibrillation ✓
- C Cardiogenic shock
- D Complete heart block
Correct answer: B. Ventricular fibrillation
Explanation
Ventricular fibrillation is the most common mechanism of sudden cardiac death in the first hours of acute MI, before structural complications like rupture can develop. Free wall rupture typically occurs 3-5 days post-MI. Cardiogenic shock requires substantial myocardial loss and develops over hours to days. Complete heart block is more common in inferior MI but rarely fatal immediately. Robbins 10th ed, Chapter 12.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.