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Paeds Casescardiology

Paeds Cases · cardiology

Explain an anomalous coronary and exercise restriction to a young athlete — OSCE

OSCE communication and shared-planning station: explaining an anomalous aortic origin of a coronary artery to a young athlete and his parent, the reason for exercise restriction, the role of further imaging and possible surgery, and the surveillance plan, with empathy, honesty and without overpromising.

osce communication and shared planning5 min readVerification in progress

Target exams

MRCPCH ClinicalRACP DCE
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Study tools

Target exams

MRCPCH ClinicalRACP DCE
Prompt
A fourteen-year-old competitive footballer and his mother attend after he collapsed with chest pain during a match. An echocardiogram suggests his left coronary artery arises from the right coronary sinus. They want to know what this means, why he cannot play, and whether he needs surgery.

Candidate instructions

You are the paediatric registrar. You have seven minutes to speak with Liam, a fourteen-year-old who plays competitive football, and his mother Mrs Chen. During a match two days ago Liam felt central chest pain and became dizzy, and he sat down just before he felt he might faint. An echocardiogram in the emergency department suggested that his left coronary artery arises from the right coronary sinus, and he has been told not to train until he is reviewed. Explain what this finding means in plain language, why he must stop competitive sport for now, what further tests and a possible operation involve, and what the outlook is — honestly and without overpromising. Answer their questions, check their understanding, and agree a plan. [1] [2]

Paediatrics Fellowship Pro

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References4ShowHide
  1. [1]Brothers JA, Frommelt MA, Jaquiss RDB, Myerburg RJ Expert consensus guidelines: Anomalous aortic origin of a coronary artery. J Thorac Cardiovasc Surg, 2017.PMID 28274557
  2. [2]Molossi S, Sachdeva S Advice to Young Athletes With Anomalous Aortic Origin of a Coronary Artery With and Without Surgery. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2025.PMID 40382130
  3. [3]Schiavone M, Gobbi C, Gasperetti A, Zuffi A Congenital Coronary Artery Anomalies and Sudden Cardiac Death. Pediatr Cardiol, 2021.PMID 34459947
  4. [4]Corrado D, Zorzi A Sudden death in athletes. Int J Cardiol, 2017.PMID 28318658
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