Cardiac Pathology VR

Before a medical student can recognise that something has gone wrong with a heart, they need to understand what a healthy heart looks like, how it beats, and how its electrical activity maps onto an ECG. Before they can apply that knowledge under clinical pressure, they need to see — not just read — what different cardiac pathologies actually do to the structure of the organ, and how those structural changes produce different presentations, different rhythms, and different outcomes.

Cardiac Pathology VR was built to close that gap. Developed in collaboration with Imperial’s Pathology Department and Faculty of Medicine clinicians, and built by the Digital Media Lab, the experience placed MBBS Year 5 students inside a self-contained VR environment — on Pico 3 headsets — that moved them through cardiac anatomy, ECG interpretation, and four narrative-driven clinical scenarios, each anchored to a real pathological heart specimen.

The specimens were captured from Imperial’s Pathology Department using photogrammetry — converting real pathological tissue into interactive 3D models that students could hold, rotate, and examine in VR, then identify the site of disease and connect it to the ECG trace and the patient outcome they had just witnessed. Around 120 students completed the experience across two days as part of the MBBS Year 5 curriculum.

Project at a Glance

Technology & Approach

Part 1: Heart Assembly & ECG

Students began by assembling a semi-transparent 3D model of a normal heart from 12 anatomical pieces — four chambers (RA, LA, RV, LV), five major vessels (aorta, SVC, IVC, pulmonary artery, pulmonary veins), and three coronary arteries (RCA, LAD, left circumflex). Using the Pico 3 controller to pick up and place each piece, students progressively reconstructed the heart. Once complete, the heart began to beat.

The beating heart then became the basis for an interactive ECG module. Students watched the wave of electrical depolarisation move through the heart — SA node to AV node, down the bundle of His — while the corresponding ECG components (P wave, PR interval, QRS complex, T wave) were highlighted in real time. Atrial fibrillation was introduced as a contrasting example: the atria visibly fibrillating, the ECG showing characteristic absent P waves and irregularly irregular QRS complexes.

Students then removed the headset for a class-based feedback activity before returning for Part 2.

Part 2: Clinical Scenarios with Photogrammetry Specimens

Part 2 presented four independent clinical scenarios, selectable in any order. Each followed the same three-stage structure: a filmed patient narrative, a 12-lead ECG challenge, and a photogrammetry specimen of the patient’s heart to examine and annotate.

The contrast between Scenarios 2 and 3 was deliberate — the same artery blocked, but different tissue findings depending on when the patient reached hospital. One specimen showed acute rupture with no fibrosis. The other showed the scarred, thinned ventricular wall of a patient who survived but never fully recovered.

Team & Collaborators

• Adrian Cowell — Innovation Lead, Faculty of Medicine · Production lead, interaction design, overall project development
• Thomas White — Digital Media Lab Lead, Imperial College London · Technical development, VR build, photogrammetry processing
• Imperial Pathology Department — Specimen access and clinical accuracy review
• Faculty of Medicine clinicians — Clinical scenario design, ECG content, and pathological interpretation

Why This Matters

Cardiac pathology teaching has traditionally relied on photographs of specimens, diagrams, and clinical vignettes presented in separate contexts. Students learn cardiac anatomy in one session, ECG interpretation in another, pathology in a third — rarely experiencing how they connect in a single clinical encounter.

Cardiac Pathology VR collapsed that into a single experience. The same student who assembled the coronary arteries in Part 1 was later asked to identify which one was blocked in a pathological specimen — and had already watched the patient whose heart that was collapse in the street. The connection between structure, electrical consequence, and clinical outcome was made tangible rather than abstract.

The use of real photogrammetry specimens — from Imperial’s own pathology collection — grounded the experience in genuine clinical material. These were not generic illustrations. They were real hearts with real disease histories, made accessible in a way that traditional pathology museum visits cannot scale.