MBBS OSCE · Cardiology
OSCE — Sudden Cardiac Death
Eight-minute OSCE station on Sudden Cardiac Death: 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 Sudden Cardiac Death.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Sudden cardiac death (SCD) is the sudden, unexpected death from a cardiac cause occurring within one hour of symptom onset (witnessed), or within 24 hours of last being seen alive and well (unwitnessed). It is the leading natural cause of death in the industrialised world, accounting for roughly 300,000 to 400,000 events per year in the United States and 4 to 5 million globally. The final common pathway in 80 to 90 percent of cases is a ventricular tachyarrhythmia (rapid polymorphic VT degenerating to ventricular fibrillation), with bradyasystole and pulseless electrical activity accounting for the rest. Coronary artery disease underlies 75 to 80 percent of adult SCD; the remainder arise fro
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 | Survivor of cardiac arrest from VF or pulseless VT, not due to a fully reversibl |
| Safety | Commotio cordis - blunt, non-penetrative chest blow over the precordium during t |
| Safety | Syncope on exertion in a young athlete or with a family history of SCD under 40 |
| 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.