Interpret a paediatric ECG — OSCE

OSCE investigation-interpretation station: interpret a 12-lead ECG of a 14-year-old girl with exertional and emotional syncope, apply the systematic age-referenced read, recognise the prolonged QTc, give the differential and the disposition, and outline the technical principles of paediatric ECG acquisition.

investigation interpretation station2 min readVerification in progress

Prompt

A 14-year-old girl is referred to the paediatric clinic after two syncopal episodes in six weeks. The first occurred during a school swimming lesson; she was pulled from the water unconscious and recovered fully within minutes. The second occurred at home on hearing sudden bad news, again with full and rapid recovery. Her GP arranged a 12-lead ECG, which is placed in front of you. The heart rate is 75 beats per minute, the rhythm is sinus, the QRS axis and the PR and QRS intervals are within normal limits, and the Bazett-corrected QT interval is 490 milliseconds. You are the paediatric registrar asked to interpret the tracing, give the differential, and outline the management and the disposition.

Candidate brief

You have this station to interpret the 12-lead ECG of a 14-year-old girl with two syncopal episodes, apply the systematic age-referenced read, recognise the prolonged QTc, give the differential and the disposition, and outline the technical principles of paediatric ECG acquisition. Treat this as a calm clinic consultation, with an explicit systematic read and a defensible plan. ^[1] ^[4]

References4Show

[1]Miliaraki M, Germanakis I Pediatric Electrocardiogram in Preparticipation Screening: Narrative Review of Normal Values in Key Features Children (Basel), 2026.PMID 41749567
[2]Sharieff GQ, Rao SO The pediatric ECG Emerg Med Clin North Am, 2006.PMID 16308120
[4]Schwartz PJ, Moss AJ, Vincent GM, Crampton RS Diagnostic criteria for the long QT syndrome. An update Circulation, 1993.PMID 8339437
[5]Gotta V, Donner B QT interval prolongation: clinical assessment, risk factors and quantitative pharmacological considerations J Pharmacokinet Pharmacodyn, 2025.PMID 41204044

Interpret a paediatric ECG — OSCE

investigation interpretation station2 min readVerification in progress

Candidate brief

References4Show

[1]Miliaraki M, Germanakis I Pediatric Electrocardiogram in Preparticipation Screening: Narrative Review of Normal Values in Key Features Children (Basel), 2026.PMID 41749567
[2]Sharieff GQ, Rao SO The pediatric ECG Emerg Med Clin North Am, 2006.PMID 16308120
[4]Schwartz PJ, Moss AJ, Vincent GM, Crampton RS Diagnostic criteria for the long QT syndrome. An update Circulation, 1993.PMID 8339437
[5]Gotta V, Donner B QT interval prolongation: clinical assessment, risk factors and quantitative pharmacological considerations J Pharmacokinet Pharmacodyn, 2025.PMID 41204044