MRCPCH Clinical Practice Questions - MRCPCH Clinical (OSCE) Exam

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In a Cardiovascular station you palpate a 4-year-old and find the apex beat in the 6th intercostal space, lateral to the mid-clavicular line, with a heave at the left sternal edge. Which interpretation should you offer the examiner?

A normal apex position for this age with no haemodynamic significance Cardiomegaly with a displaced apex and a right ventricular heave suggesting volume/pressure load Dextrocardia, since the heave indicates a mirror-image heart Pectus excavatum causing apparent displacement only

Correct Answer:

Cardiomegaly with a displaced apex and a right ventricular heave suggesting volume/pressure load

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