55 years old woman with history of episodic atrial fibrillation and severe mitral regurgitation who was on warfarin from 1 year ago, underwent Mitral Valve Replacement (MVR) 4 days ago. She was transferred to post-ICU ward in sinus rhythm but the palpitation suddenly begun (below ECG). 

Her vital signs were as follows: BP 95/60, No fever, Acceptable Respiratory Rate, Heart Rate 130.  

Bed-side Echocardiography showed moderate Left Ventricle (LV) dysfunction (EF 35-40%), mild Right Ventricle (RV) dysfunction, Good MV bileaflet motion and dilated Left atrium (LA).

What is your diagnosis and reasonable therapeutic approach? 

A 60 y/o lady underwent echocardiography for evaluation of chest pain.

What is your most likely diagnosis for our patient?

36-year-old female with  hypercholesterolemia presents to the emergency room with 3 hours of chest pain and the following ECG.

How would you manage this patient based on this ECG?

A middle-aged lady with wide complex tachycardia underwent EPS. ECG of Arrhythmia and an EP tracing of high RA pacing are shown below:

What is the most probable diagnosis?

A female patient aged 53 years, with a medical history of aortic valve replacement (AVR), mitral valve replacement (MVR), and tricuspid valve repair (TVr) five years ago, presented at the medical facility without any symptoms but with a prolonged withdrawal from warfarin for several months. The patient was admitted, and heparin therapy was initiated along with a transthoracic Doppler echocardiography (TDI TTE) examination and fluoroscopy. 

Based on the results obtained from the TDI TTE and flouroscopy what do you consider the most appropriate course of action?

A 25-year-old multiparous woman, seven weeks after her third caesarean delivery, experiences shortness of breath and bilateral lower limb edema. During the initial evaluation, pulmonary rales are heard, and the echocardiography reports an EF=20%. The patient is not taking any supplementary drugs and does not mention any family history of heart problems. A coronary CT angiography was requested and reported normal results. 

Based on the diagnosis, which option is incorrect?

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

Which statement is TRUE?

A young man with palpitation underwent EPS. An EP trace is given:

Three beats are marked, explain each of them separately :

A 64-year-old male with a past medical history of CRT-P implantation 5 years ago,(with no medical record document) came to ER with chief complaint of syncope yesterday at 5 pm.

Here you can find the ECG and the arrhythmia episode concomitant with the syncope event.
What is the best choice?

A 67 years old male with hx of CABG 10 years ago and PTE last year (since then he is on anticoagulant therapy), presented to ER complaining of ACP. ECG is shown below;

What is the next step?

A 58-year-old lady with ICD_VR who presented with diaphragmatic twitching from 4 days ago. In the surface ECG, no capture is seen during the diaphragmatic twitching, but at the same time analysis of the device, the V pace is seen at a rate of 45 beats/min. The lead impedance was also 380 ohms, which has droped by about 250 ohms in the last 4 days. It denies any palpitation, chest pain, dyspnea and ICD shock. What is the most probable diagnosis for this patient?

What is the diagnosis?

55 y/o man with crushing chest pain & diaphoresis,

ECG is shown:

According to ECG, can you guess the culprit vessel?

a 40 y/o man with a history of hybrid TEVAR operation underwent CT angiography for routine follow up:

CT angiography is shown:

In CT angiography there is an incidental congenital heart defect, can you guess what defect is shown?

A 61-y/o patient with a history of atrial fibrillation and 3VD is candidated for CABG. He was receiving rivaroxaban 20 mg daily at the time of admission.

What is your suggestion for perioperative management of his antithrombotic regimen?

A 75 y/o lady underwent echocardiography for evaluation of dyspnea. Echocardiography is shown:

Which statement is TRUE about the patient?

A 28 years old man with preexcitation and episodes of palpitations. ECG is shown below:

Regarding to accessory pathway location, what procedure related complication does not threat the patient?

A middle-aged patient with a history of atrial septal defect (ASD) repair underwent an electrophysiology study (EPS) with Precision. Below, you can find the propagation and sparkle map.

What is the most probable mechanism of arrhythmia? 

A middle-aged man with a history of accessory pathway ablation came to our clinic with chief complaint of recurrent palpitations.
(ECG:1-2)
He was scheduled for EP study, and the accessory pathway was successfully ablated.
The day after, he was complaining of pleuritic chest pain.(ECG :3)

Bedside echo revealed mild pericardial effusion.

which statement is not correct?

A middle aged lady,came to our clinic with chief complaint of multiple episodes of palpitation.
here are the EP tracings.

Which arrhythmia is the least possible diagnosis?

A 67-year-old man with a history of frequent palpitations underwent EPS. Below you can find two tracings.

Which statement is WRONG?