Case #367-Ali Bozorgi

History:

A middle-aged lady with palpitations underwent EPS, below you can see the EP tracings:

Question:

What is the most probable diagnosis?

Case #364-Ali Bozorgi

History:

A 62 year-old-man was referred with a history of palpitations, LVEF=40%, and mild coronary artery disease. Two sets of ECG are shown.

Question:

Which of the option is NOT evident in these ECGs?

Case #528-Samane Mohamadi

History:

A 31 years old woman presented with paroxysmal palpitation.here there is her ECG Holter.

Question:

Which statement is NOT correct?

Case #618-Ali Bozorgi

History:

A middle-aged woman presented to the ER with pre-syncope. Below are the serial ECGs taken in the ED:

Question:

Which arrhythmias are seen? 

Case #107-Motahare Hatami

History:

65 y/o man came to ED complaining of episode of typical chest pain.

ECG was shown:

Question:

According to ECG, can you guess the culprit vessel?

Case #523-Ali Bozorgi

History:

A 45 years old electrician with a history of ICD implantation, experienced ICD shock. Below you can find plot diagram and EGM of the event. 

Question:

which statement is WRONG?

Case #777-Siroos Nasiri

History:

A 39-year-old man with history of DCM and reduced LVEF (25%), presented with palpitations and frequent PVC on surface ECG and Holter monitoring (PVC Burden: 40%), referred for ablation. EPS was done by 3D NAVX/Precision mapping guide. Initially, Based on surface ECG which was compatible with LV summit origin, mapping was started within CS, the best earliest signal was found in GCV (-42ms). RF applied on aforementioned area, but PVCs did not disappear. So, mapping was done via retrograde trans-aortic approach. After maintaining safe distance from LM,LCX and LAD by coronary angiography and considering correspondent point from epicardial mapping, the best earliest point was found around ILT area (-44ms). RF applied on aforementioned area and PVCs disappeared immediately.

 

Four fluoroscopic views and surface ECG are shown.

Question:

Which of the fluoroscopic views is in favor of catheter ablation position in the ILT (Inter Leaflet Triangle)?

History:

A 70 years old man with a history of hypothyroidism and CHF came to the clinic without any complaints.
3 years ago, An ICD DR was implanted for him.
He takes these drugs:
Amiodarone 200mg BD, ASA 80mg Daily, Pantoprazole 40 mg Daily, Losartan 25 mg Daily, spironolactone 25mg Daily;

Question:

According to the shown ECG, which action is more correct?

Case #152-Motahare Hatami

History:

A 52 y/o lady was admitted to hospital 3 days ago. She received thrombolytic 3 days ago based on initial diagnosis of inferior STEMI .After 3 days, chest pain recurred again, and you called for evaluation of the chest pain.

ECG of day 1,2 & 3 are shown:

Question:

Based on most likely diagnosis, What is your recommendation?

Case #662-Sarah Taaghi

History:

During electrophysiology study, arrhythmia is easily induced with atrial burst pacing. You can find the tracing in below.

Question:

what is the correct statement?

Case #133-Kaveh Hosseini

History:

A 45 years old women came to office with mildly positive MPI scan. She was worried about the results. She was hypertensive with family history of premature coronary artery disease. Cardiologist decided to perform coronary angiogram. 
Angiogram is shown:

Question:

What is the diagnosis and the appropriate treatment strategy? 

History:

A 24-year-old woman complains of pleuritic chest pain since two days ago.  The patient's pain is constant and has not decreased. The patient mentions the history of taking bodybuilding supplements and has complained of chronic cough for the past six months.

He did not complain of a recent cold or coryza symptoms.

  DH: Negative

  FH: Negative

  Vital signs: BP:120/80, PR:75, RR:18, T:37℃

  Lab findings: WBC:14000(N:70%), Plt:330,000 , CRP:NL, Trop:1200

Question:

According to angiography, which finding is incorrect?

Case #513-Ali Bozorgi

History:

Here is a video of a patient in the ICU. The cardiology resident in charge transiently turned off the patient's temporary pacemaker, which caused the patient to go into asystole.

Question:

How can this be?

History:

70 y/o man with history of CABG underwent coronary angiography for evaluation of exertional chest pain .

Question:

which statement is TRUE about the patient?

Case #119-Motahare Hatami

History:

17 y/o girl underwent catheterization for evaluation of congenital heart disease. Catheterization is shown:

Question:

Which one of the following congenital anomaly could NOT explain this catheterization course?

Case #638-Shayan Shahi

History:

A 72-year-old man with a known history of Parkinson’s disease presented to our ED with a chief complaint of palpitations. Below is the intracardiac EGM from his EP study.

Question:

What is the diagnosis, and what is the most likely mechanism behind the variation in Tachycardia Cycle Length (TCL)?

Case #8-Ali Bozorgi

History:

A 40 y/o lady came to ED complaining of acute retrosternal chest pain which was lasted one hour.The patient was asymptomatic at the time of visit, past medical history was unremarkable.The ECG was shown below. Bedside echo showed LVEF about 40 % with regional wall motion abnormality in mid ventricular part of inferior, posterior, anterior, lateral and anteroseptal of LV.

First  hs-cTnT = 58 ng/l  (with upper limit of 24 ng/l)

Question:

What is the most likely diagnosis for this patient?

History:

A 54-year-old male diabetic patient presents to the emergency department with complaints of atypical chest pain. The electrocardiogram (ECG) is presented below for analysis. 

Question:

 What is the most appropriate course of action in this clinical scenario?

Case #471-Ali Bozorgi

History:

A patient with Dual chamber ICD came for analysis, below you can find analysis tracing and chest X-ray.

Question:

According to analysis and chest x-ray, what is the probable diagnosis?

Case #284-Ali Bozorgi

History:

A 32 years patient with recurrent palpitations underwent EPS and ablation. ECG and EP tracings are shown:

Question:

Which statement is TRUE?

In Loving Memory of

Dr. Maryam Khoshnevis

MD, Cardiologist

Fellowship of Echocardiography

Faculty member of TUMS

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