A 50 years old lady with history of unsuccessful RF ablation underwent EP, Arrhythmia was easily inducible with programmed stimulation, below you can see surface ECG, Entrainment maneuver and also 3D mapping with precision:

What is the mechanism of arrhythmia?

A 75 y/o lady underwent coronary angiography. she had a history of pacemaker implantation 10 years ago. A shot of her angiography is shown:

Can you guess the kind of pacemaker lead?

A 52 y/o man underwent echocardiography for evaluation of dyspnea on exertion .

Based on echocardiography could you guess the mechanism of severe MR?

A 21-year-old man suffered a cardiac arrest during physical activity. Cardiopulmonary resuscitation (CPR) was performed for a duration of twenty minutes, and the patient was subsequently transported to the hospital. According to the EMS personnel, the patient had a VT rhythm during cardiac resuscitation, as indicated by the electrocardiogram and echocardiography.

 Which option is incorrect?

A 45 y/o lady came to ED complaining of atypical chest pain. According to ECG changes, two sets of troponin were sent, which came negative.

ECG & Coronary angiography were shown:

Which one of the following was not seen in the angiography?

A 70 y/o man with left upper quadrant and hemothorax pain from last night 

He had performed EVAR last year due to Abdominal Aorta Aneurysm

Bp:100/70 PR:100/min  RR:18  Room air O2 sat:94%

WBC:12700 PMN 78% Hb:6.7 PLT:177000

Cr:1.7, Negative Tn

Abdominopelvic CT with IV contrast was done

What is your diagnosis and treatment?

A 36-year-old woman with a medical history of coronary artery bypass grafting (CABG) performed 2 years ago, insulin-dependent diabetes mellitus (DM), hyperlipidemia, and hypertension presented to the emergency department (ED) with complaints of fever and severe weakness lasting for 2 days. An electrocardiogram (ECG), displayed below, suggests the presence of Brugada syndrome. Additionally, while sitting on a chair in the ED, the patient experienced a syncopal episode. Consequently, the decision was made to admit the patient based on the syncope and ECG findings.

A coronary angiogram conducted 1 year ago revealed triple-vessel disease (3VD) and a patent left internal mammary artery (LIMA) graft on the left anterior descending artery (LAD). The posterior descending artery (PDA) demonstrated a patent saphenous vein graft (SVG), and there was significant diffuse stenosis observed in the SVG on the obtuse marginal (OM) branch, for which medical treatment was planned.

Troponin levels were negative upon presentation and remained so throughout the patient's admission.

Also, the ECG can be seen below.

Among the following measures, which one do you consider unnecessary?

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

According to angiography, which finding is incorrect?

A 40 y/o lady with history of valve surgery is admitted to hospital because of left hemiparesis, she only took warfarin as her medication & her last INR was about 2.2. Echocardiography is shown.

According to the echocardiography, what is your plan for patient ?

A middle-aged lady with frequent palpitations, EP tracings are shown below.

What is the most probable diagnosis?

An 82-year-old man with a history of TAVR and PPM-DR insertion due to transient AV Block after TAVR has presented for device analysis with this ECG without any symptoms.

What's your interpretation?

A 50 y/o man underwent echocardiography for assessment of heart murmur.

What is your most likely diagnosis?

The image below shows  fluoroscopic views (LAO & RAO) of mitral annulus accessory pathway ablation via retrograde trans-aortic approach in three patients: A, B, and C

Which one is related to the Posteroseptal accessory pathway ablation?

A 35 y/o man with history of Tetralogy of Fallot surgery in childhood underwent Echocardiography for routine follow up:

Which one of the following was not seen in this Echocardiography?

A 52-year-old lady with frequent palpitations, below you can find the ECG and EP tracing.

What is the most likely diagnosis?

A middle-aged man with a history of frequent admissions due to tachyarrhythmia and two unsuccessful ablation sessions. ECG and 3D mapping from an electrophysiology study (EPS) are shown:

Based on ECG and 3D mapping what is Wrong about this case?

A 57-year-old woman with palpitations and manifest preexcitation and WCT in surface ECG, referred for ablation. 

Surface ECG during sinus rhythm, arrhythmia, ECG during EPS before ablation, full preexcitation, arrhythmia induction and after ablation are shown, respectively.

What is the most likely diagnosis of the arrhythmia and the accessory pathway location?

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

Which arrhythmias are seen? 

A 38-year-old stable male patient with an unrecorded history of atrial fibrillation (AF) rhythm presented to the Emergency Department (ED) with a chief complaint of palpitations. The electrocardiogram (ECG) is displayed below.

The patient has no drug history.

Upon reviewing the patient's condition, what do you think about the drug of choice? Furthermore, how do you decide if the preferred drug is not available? (Answers coming up respectively)

A 58 years old man with several episodes of syncope once in supine position. Baseline ECG showed RBBB and LAHB (bifascicular block). LVEF=55%, EPS done. EP tracing is shown:

What is the tracing interpretation and next plan?