ECG interpretation 2

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 he has for you.

Patient details:
Name: Paul Smith
DOB: DD/MM/YYYY
Age: 52
Basic info: current cough plus productive sputum (pneumonia), hypertension, diabetes, clinically stable, no other medical history

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 decide a need for anticoagulation?

Question 6: Outline the immediate management of this patient?

  • No previous history of atrial fibrillation
  • CHA2DS2-VASc - >2
  • HAS-BLED - <1

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

Atrial fibrillation
Irregularly irregular rhythm
all-markschemes.questions

Name 3 symptoms which this patient may be presenting with?

Dyspnoea
Chest pain
Palpitations
Sweating
Syncope
all-markschemes.questions

Name 3 further investigations you would do?

FBC
U+Es
CXR
Clotting profile
TFTs
all-markschemes.questions

What scoring system would you use to decide a need for anticoagulation?

CHA2DS2-VASc
HAS-BLED
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Outline the immediate management of this patient?

Rate control - beta blockers e.g. bisoprolol, metoprolol OR rate-limiting calcium channel blocker e.g. diltiazem, verapemil
Anticoagulation - DOACs e.g. apixaban, dabigatran
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.