MBBS OSCE · Paediatrics
OSCE — Congenital Heart Disease
Eight-minute OSCE station on Congenital Heart Disease: focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Congenital Heart Disease.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Congenital heart disease (CHD) = structural heart defect present at birth. Incidence: 8-9 per 1000 live births. Classification: acyanotic (left-to-right shunt: VSD, ASD, PDA, AVSD; obstructive: coarctation, AS, PS) vs cyanotic (right-to-left shunt: TOF, TGA, tricuspid atresia, TAPVD, HLHS). Duct-dependent lesions (TGA, HLHS, critical PS/AS, severe coarctation) present with collapse at duct closure — maintain PGE1. Hyperoxia test distinguishes cardiac from pulmonary cyanosis.
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Recognise severe Congenital Heart Disease |
| Safety | Escalate unstable patients immediately |
| Communication | Clear 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.