MBBS OSCE · cardiology

OSCE — Arrhythmogenic Cardiomyopathy

Eight-minute OSCE station on Arrhythmogenic Cardiomyopathy: focused history, examination priorities, investigations, emergency and definitive management.

8 min stationVerification in progress
On this page
Study tools

Exam tags

NEET-PGINICETUSMLEPLAB

Brief (to candidate)

You will assess a patient with a presentation consistent with Arrhythmogenic Cardiomyopathy.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.

Clinical context

Arrhythmogenic cardiomyopathy (ACM) is an inherited heart-muscle disease in which progressive fibro-fatty replacement of ventricular myocardium (classically the right ventricle) produces ventricular arrhythmias, heart failure and sudden cardiac death (SCD) in apparently healthy young people — most notably competitive athletes. Inheritance is usually autosomal dominant and the genes are predominantly desmosomal (PKP2 plakophilin-2, DSP desmoplakin, DSG2 desmoglein-2, DSC2 desmocollin-2, JUP plakoglobin); non-desmosomal genes include TMEM43, LMNA, PLN, DES, CDH2, SCN5A, CTNNA3. The ECG hallmark is the epsilon wave (a low-amplitude deflection at the end of the QRS in V1-V3) with T-wave inversion in V1-V3 in the absence of complete right bundle branch block; diagnosis uses the 2010 Modified Task Force Criteria, extended to the left ventricle by the 2020 Padua criteria. Management is restriction from competitive and high-intensity sport, a beta-blocker first-line, an ICD chosen by risk category, and catheter ablation for drug-refractory ventricular tachycardia.[1][3][4]

Candidate tasks

  1. Clarify onset, severity, associated features, and red-flag symptoms.[1]
  2. State focused examination priorities.
  3. List first-line investigations and any named score/criteria.
  4. Give immediate resuscitation steps.
  5. Outline definitive management with doses/routes where standard.
  6. Name complications and disposition (ward / HDU / theatre / discharge safety-net).
  7. Mention one special-population modifier (pregnancy, child, elderly, CKD).

Examiner checklist

DomainPass behaviours
DefinitionCorrect working diagnosis language
AssessmentFocused, prioritised, red flags sought
InvestigationsAppropriate first-line + interpretation
Emergency careABC / time-critical actions first
Definitive careSpecific drugs/procedures, not generic phrases
SafetyYoung athlete with palpitations, syncope or near-syncope during exertion - consi
SafetyEpsilon waves, T-wave inversion V1-V3 (without RBBB) and RV outflow-tract ectopy
SafetySurvivor of sudden cardiac arrest with structurally abnormal RV or biventricular
CommunicationClear plan and safety-netting

Model outline

Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.[2][4]

References4Show
  1. [1]Marcus FI, McKenna WJ, Sherrill D, et al. Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the task force criteria Circulation, 2010.PMID 20172911
  2. [2]Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death Eur Heart J, 2022.PMID 36017572
  3. [3]Corrado D, Perazzolo Marra M, Zorzi A, et al. Diagnosis of arrhythmogenic cardiomyopathy: The Padua criteria Int J Cardiol, 2020.PMID 32561223
  4. [4]Iezzi L, Sorella A, Galanti K, et al. Arrhythmogenic cardiomyopathy diagnosis and management: a systematic review of clinical practice guidelines and recommendations with insights for future research Eur Heart J Qual Care Clin Outcomes, 2025.PMID 40386976
OSCE — Arrhythmogenic Cardiomyopathy · MBBS OSCE · NeetVellum