OSCE — Myocarditis · MBBS OSCE

Brief (to candidate)

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

Clinical context

Myocarditis is an inflammatory disease of the myocardium confirmed by histological, immunological and immunohistochemical criteria, most commonly caused by viruses (coxsackievirus B3, adenovirus, parvovirus B19, enteroviruses, SARS-CoV-2). It presents with a clinical triad of chest pain, heart-failure symptoms and arrhythmia, frequently after a viral prodrome 1 to 2 weeks earlier. Diagnosis is suspected on chest pain plus raised high-sensitivity troponin with normal coronary angiography, and confirmed by cardiac MRI using the Lake Louise Criteria; endomyocardial biopsy remains the gold standard. Management is predominantly supportive (heart-failure therapy, arrhythmia control, activity restr

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	Young adult with viral prodrome 1 to 2 weeks ago, now chest pain, raised troponi
Safety	Fulminant myocarditis - rapid-onset severe heart failure or cardiogenic shock wi
Safety	Giant cell myocarditis - ventricular arrhythmia, high-grade AV block, rapidly pr
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.