Explain complete heart block and the pacemaker to a parent — OSCE

Candidate instructions

You are the paediatric registrar. You have seven minutes to speak with Mrs Tran, whose two-day-old daughter Mai was found at the routine postnatal check to have a heart rate of fifty-five beats per minute. Mai is mildly mottled and feeding slowly, and a twelve-lead ECG has shown complete heart block with a narrow-QRS escape rhythm. Mrs Tran has systemic lupus erythematosus and is known to be anti-Ro positive. She saw the registrar's worried face and overheard the word pacemaker. Explain what complete heart block is in plain language, what caused it and whether her lupus is to blame, what the pacemaker involves and whether Mai will need it for life, what the prognosis is, and what it means for any future pregnancies. Answer her questions, check her understanding, and agree a plan. ^[2]