ECG interpretation 1

Interpret an ECG for an acutely unwell patient

Candidate Instructions 🧒

You are the FY1 working in A&E.

Your consultant asks you to talk through the ECG which you have just been handed by one of the nurses.

Please answer all of the questions which she has for you.

Patient details:
Name: Mrs Lisa Holmes
DOB: DD/MM/YYYY
Age: 64
Basic info: hypertension, hypercholesterolaemia, smoker, no known cardiac problems, clinically stable

Recommended time: 5 minutes


Station Material (ONLY OPEN WHEN PROMPTED)

Media 1

Actor Instructions 🤒

Please open Media 1 (candidate instructions - station material - media 1)

Question 1: Outline your systematic approach for interpreting ECGs?

Question 2: What is your diagnosis? Why?

Question 3: Name 3 symptoms which this patient may be presenting with?

Question 4: Name 3 further investigations you would do?

Question 5: What scoring system would you use to risk stratify this patient?

  • GRACE - >3% high-risk

Question 6: Outline the immediate management of this patient?

Mark Scheme ✍️

Questions

Outline your approach to interpreting this ECG?

Patient name + DOB
Date + time of ECG
ECG calibration
Rate, rhythm and axis
P waves
PR interval
QRS complex
ST segment
QT interval
T waves
all-markschemes.questions

What is your diagnosis? Why

NSTEMI
Global ST-depression
all-markschemes.questions

Name 3 symptoms which this patient may be presenting with?

Crushing chest pain
Pain radiation - left arm/neck/jaw
Nausea
Sweating
Shortness of breath
all-markschemes.questions

Name 3 further investigations you would do?

Serial troponin
Serial ECG
U+Es
FBC
CXR
all-markschemes.questions

What scoring system would you use to risk stratify this patient?

GRACE
all-markschemes.questions

Outline the immediate management of this patient?

300mg aspirin
Fondaparinux
Prasugrel/ticagrelor
Unfractionated heparin
PCI
all-markschemes.questions

Convert your points into a realistic exam mark

10:00
Accurate scores
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First-decile strategy
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Diagnostic expert
Listen to murmurs, interpret CXRs and read ECGs. Integrated media to help you become a diagnostic expert.